2019 Volume 29 Issue 1 Pages 64-68
The patient was an 86-year old woman with diabetes mellitus, who presented with severe otorrhea and otalgia of the right ear after receiving treatment for 70 days at another clinic. Multidrug-resistant Pseudomonas aeruginosa (MDRP) and methicillin-resistant Staphylococcus aureus (MRSA) were detected in the otorrhea. She was referred to our hospital and administered antibiotic treatment under the diagnosis of malignant external otitis; the otorrhea was positive for only MDRP at our hospital, but antibiotic treatment was administered for MRSA as well as MDRP. In addition, surgery was performed to enable drainage and discriminate possible malignant tumors. During the treatment course, antibiotic treatment with vancomycin was changed due to the development of vancomycin-induced kidney injury; finally, after treatment at our hospital for 75 days, and follow-up outpatient treatment for 20 days, the patients’ symptoms, laboratory data, and imaging findings were improved. No recurrence was observed at follow-up of at least 1 year. This case report highlights that it is important to conduct biochemical tests including that of kidney function and therapeutic drug monitoring due to the potential of vancomycin to cause kidney injury even at a blood level of within treatment range.
