A case of malignant external otitis treated with short-term intravenous antibiotic therapy and long-term oral antibiotic therapy

Abstract

Malignant external otitis (MEO) is an invasive infection of the external auditory canal and skull base that typically occurs in elderly patients with diabetes mellitus. Most such patients require long-term intravenous antibiotic therapy. We herein report a patient with MEO who was treated with short-term intravenous antibiotic therapy and long-term oral antibiotic therapy. An 83-year-old male patient with a history of diabetes mellitus presented with otorrhea and otalgia. External otitis was also observed in the right ear. His symptoms failed to improve despite treatment with oral antibiotics, and he developed right facial paralysis two weeks after the start of treatment. Based on the findings of a histopathological examination of the external auditory canal, cultures of otorrhea fluid, computed tomography, and magnetic resonance imaging, we diagnosed MEO without skull base osteomyelitis. The patient was subsequently treated with intravenous antibiotics for 9 days and then oral antibiotics for 25 weeks. While his facial paralysis persisted, otorrhea and otalgia resolved, with no signs of recurrence for 18 months.