malignant otitis externa

what is malignant otitis externa also called?

necrotising otitis externa (NOE) - emergency

what is the most common cause of malignant otitis externa?

pseudomonas aeruginosa

what is the main risk factor for malignant otitis externa?

immunocompromised pts

which pts count for 90% of otitis externa cases?

diabetes

what happens to the infection in malignant otitis externa?

infection goes from soft tissues of ear canal to bony

what can malignant otitis externa progress into?

temporal bone osteomyelitis

what are the complications of malignant otitis externa?

- facial nerve damage and palsy

- other cranial nerve involvement (CN IX, CN X, CN XI)

- meningitis

- intracranial thrombosis

- death

what are the clinical features?

- severe, unrelenting, deep-seated otalgia

- temporal headaches

- purulent ottorhoea

- dysphagia, hoarsness, facial nerve dysfunction

what can be used to assess the extent of infection?

imaging - CT

what is the first line management for malignant otitis externa?

urgent referral to ENT

what medication would be given?

IV antibiotics - beta lactam and ciprofloxacin