Malignant external otitis: The shifting treatment paradigm

Publication date: Available online 25 May 2017
Source:American Journal of Otolaryngology
Author(s): Daniel A. Carlton, Enrique E. Perez, Eric E. Smouha
ImportanceMalignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat.ObjectiveDetermine if there has been a shift in the microbiology and outcomes of MEO.DesignA retrospective case series at a tertiary care institution.SettingInpatient and outpatient tertiary care hospital.Participants12 cases of recent MEO were reviewed.Main Outcomes and measuresThe primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO.ResultsOnly 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses.ConclusionsSelect cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.



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