Malignant Otitis Externa and Stroke
  • Marta Catarino Manso
    Department of Internal Medicine, Hospital de Egas Moniz, Lisboa
  • Simão C. Rodeia
    Department of Internal Medicine, Hospital de Egas Moniz, Lisboa
  • Sofia Rodrigues
    Department of Internal Medicine, Hospital de Egas Moniz, Lisboa
  • Pedro Cavilhas
    Department of Otorhinolaryngology, Hospital de Egas Moniz, Lisboa
  • Raquel Domingos
    Department of Internal Medicine, Hospital de Egas Moniz, Lisboa


Malignant otitis externa, stroke, skull base osteomyelitis, internal carotid vasculitis


Malignant otitis externa (MOE) is an aggressive but benign entity which evolves into skull base osteomyelitis. An 81-year-old female patient was admitted for left hemiparesis and homonymous hemianopia. She complained of headache radiating to the right cervical area. A recent history of recurrent otitis media was present. Head and neck imaging showed an ischemic infarction (right temporo-occipital) and a parapharyngeal soft tissue mass originating in an external and medial ear infection. Culture samples revealed Pseudomonas aeruginosa infection leading to the diagnosis of Malignant otitis externa (MOE). Parenteral antibacterial therapy and hyperbaric oxygen therapy resulted in improvement.



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    Figure 2. Gallium67 scintigraphy showing hyperfixation in the corresponding area. downloads: 0
    Figure 1. Magnetic resonance imaging showing extensive soft tissue mass with extension to bony structures of skull base and ischemic lesion of the right occipital lobe downloads: 0

    Published: 2016-06-07
    Issue: Vol. 3 No. 4 (view)

    How to cite:
    Catarino Manso M, Rodeia SC, Rodrigues S, Cavilhas P, Domingos R. Malignant Otitis Externa and Stroke. EJCRIM 2016;3 doi:10.12890/2016_000387.