Case Reports
Two Cases of Malignant External Otitis: Case Report
2019 Volume 7 Issue 2 Pages 96-100
Details
2019 Volume 7 Issue 2 Pages 96-100
Background:
Malignant external otitis is a necrotizing external ear inflammation that develops in elderly patients with diabetes mellitus and is potentially fatal. However, treatment methods and evaluation of the therapeutic efficacy thereof are not yet established.
We report our experiences with 2 cases of malignant external otitis that presented at our hospital, to identify effective therapeutic regimens and introduce methods for evaluating the effectiveness thereof.
Case presentation:
Case 1: A 74-year-old man presented with left otalgia, otorrhea, and facial nerve palsy. He was diagnosed with malignant external otitis and skull base osteomyelitis. Antibacterial medication was then administered intravenously but was discontinued on the 14th day because of side effects. On subsequent recurrence of symptoms, the patient was readmitted, and intravenous antibacterial therapy was resumed; however, he died.
Case 2: An 85-year-old man presented with left otalgia and otorrhea. He was also diagnosed with malignant external otitis and skull base osteomyelitis, and antibacterial medication was then administered intravenously. He did not experience side effects. Antibacterial administration was terminated 28 days after treatment initiation. A decrease in the erythrocyte sedimentation rate was used as the index for evaluating therapeutic effects. Currently, the patient is being treated with an oral antibiotic drug, and no recurrence of symptoms has been noted so far.
Conclusion:
Based on our experiences, intravenous administration of antibacterial medication for 4 to 6 weeks, followed by oral antibiotic treatment for 6 to 12 months, can be considered an effective treatment for malignant external otitis.
In addition, erythrocyte sedimentation rate appears to be effective for evaluating the treatment efficacy.
