Malignant Otitis Externa and Stroke
KeywordsMalignant 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.
Guevara N, et al. Initial management of necrotizing external otitis: errors to avoid. Eur Ann Otorhinolaryngol Head Neck Dis2013;130:115–121.
Grandis JR, Branstetter BF, Yu VL. The changing face of malignant (necrotising) external otitis: clinical, radiological, and anatomic correlations. Lancet Infect Dis 2004;4:34–39.
Carfrae MJ, Kesser BW. Malignant otitis externa. Otolaryngol Clin North Am 2008;41:537–549.
Bellia E, Galea R, Vassallo MA. Acute confusion and sudden deterioration in an elderly patient with necrotizing otitis externa. Eur Geriatr Med 2012;3:242–243.
Philips JS, Jones SE. Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa. Cochrane Database Syst Rev 2013;5:CD004617.
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