MyMedR

Otitis externa tropica

Gerrard PN

Lancet, 1899;154:837-8.

DOI: 10.1016/S0140-6736(01)40162-0

Matched MeSH terms: Otitis Externa

Inflammation of the external auditory meatus from the practical point of view

SWEEDMAN KF

Med J Malaya, 1960 Jun;14:232-41.

PMID: 13774254

Matched MeSH terms: Otitis Externa/therapy*

Fulltext Otitis externa complicated with chloramphenicol ear drops-induced perichondritis

Mohamad I, Johan K, Hashim H, Nik Othman N

Malays Fam Physician, 2014;9(1):28-9.

PMID: 25606295 MyJurnal

Otitis externa is a common condition of the ear. It is manifested as narrowing of the lumen owing to the edematous swelling of the ear canal lining. Perichondritis may occur independently or as a complication of the otitis externa. We report a case of perichondritis after using a topical ear drop. Changing the medication provides immediate resolution of the condition.

Matched MeSH terms: Otitis Externa

Fulltext Facial nerve palsy in otitis externa: A red flag?

Badaruddin A, Choo MM

Malays Fam Physician, 2021 Mar 25;16(1):117-120.

PMID: 33948150 DOI: 10.51866/cr1108

Otitis externa is an infection of the external auditory canal. It rarely results in facial palsy except in severe cases such as necrotizing otitis externa, which is a life-threatening invasive infection of the external auditory canal. Early recognition with prompt and appropriate treatment of necrotizing otitis externa is crucial to prevent more sinister complications. Here we report a case of an elderly gentleman who presented with otitis externa and developed facial palsy a month later. We identified possible problems that may have led to the complication so that such an occurrence can be prevented in the future.

Matched MeSH terms: Otitis Externa

Fulltext A Case Series of Malignant Otitis Externa Mimicking Malignancy

Selvamalar V, Othman NAN, Daud MK

Acta Medica (Hradec Kralove), 2021;64(1):36-41.

PMID: 33855957 DOI: 10.14712/18059694.2021.6

Malignant otitis externa is an inflammation of the external auditory canal with preceding osteomyelitis of the temporal bone and the adjacent structures that could be potentially lethal. Malignant otitis externa may present with cranial nerve involvements and massive spread of disease mimicking nasopharyngeal carcinoma or any other malignancies on imaging. Two elderly patients who presented with severe otalgia and significant facial nerve palsy and lower cranial nerve palsies showing extensive spread of disease are reported in this case series. They both had resolution of disease after a prolonged course of antibiotics and cortical mastoidectomy for disease clearance in one of them.

Matched MeSH terms: Otitis Externa/diagnosis*; Otitis Externa/pathology; Otitis Externa/therapy*

Inflammation of the external ear in acute chikungunya infection: Experience from the outbreak in Johor Bahru, Malaysia, 2008

Javelle E, Tiong TH, Leparc-Goffart I, Savini H, Simon F

J Clin Virol, 2014 Apr;59(4):270-3.

PMID: 24556566 DOI: 10.1016/j.jcv.2014.01.011

The re-emerging invalidating chikungunya disease has recently extended to temperate areas. Other alphaviruses can also present with febrile arthalgias. Dengue virus transmitted by the same species of mosquitoes may cocirculate, leading to dual infections and concurrent epidemics. Although these diseases share similar clinical features, their prognoses considerably differ. Prominent and prolonged articular disorders are more consistent with chikungunya virus, whereas haemorrhages make the gravity of dengue infection. Specific symptoms are required, especially when diagnostic tests are not available or performable at a large scale. Indeed, early clinical suspicion of a vector-borne disease is crucial to isolate the first cases in the course of an outbreak, and discrimination between arboviruses help to optimal management of patients. No specific chikungunya clinical sign has been yet reported. We highlight here the high prevalence (about 25%) of acute ear redness in infected people during the 2008 chikungunya outbreak in Jahor Bahru in Malaysia. Nine consenting patients are more precisely described. Ear chondritis could be sensitive diagnostic criterion of the acute stage of chikungunya, every physician - even in occidental non endemic areas - should be aware of.

Matched MeSH terms: Otitis Externa/diagnosis; Otitis Externa/etiology*; Otitis Externa/epidemiology*; Otitis Externa/pathology

Fulltext Use of gallium-67 in the assessment of response to antibiotic therapy in malignant otitis externa--a case report

Paramsothy M, Khanijow V, Ong TO

Singapore Med J, 1997 Aug;38(8):347-9.

PMID: 9364890

Malignant Otitis Externa (MOE) can cause considerable morbidity and mortality in affected individuals. The outlook is now much improved with the use of ciprofloxacin, but it is important to ascertain that the infection has been completely eradicated before stopping treatment, as undertreatment may lead to a recurrence which is usually more resistant than the initial infection. Gallium-67 Single Photon Emmision Computerised Tomography (SPECT) is a sensitive and cost effective tool in monitoring the disease activity of MOE, and should be used in the assessment of the response to antibiotic therapy.

Matched MeSH terms: Otitis Externa/drug therapy*; Otitis Externa/radionuclide imaging*

Biofilm production by pathogens associated with canine otitis externa, and the antibiofilm activity of ionophores and antimicrobial adjuvants

Chan WY, Hickey EE, Page SW, Trott DJ, Hill PB

J Vet Pharmacol Ther, 2019 Nov;42(6):682-692.

PMID: 31503362 DOI: 10.1111/jvp.12811

Otitis externa (OE) is a frequently reported disorder in dogs associated with secondary infections by Staphylococcus, Pseudomonas and yeast pathogens. The presence of biofilms may play an important role in the resistance of otic pathogens to antimicrobial agents. Biofilm production of twenty Staphylococcus pseudintermedius and twenty Pseudomonas aeruginosa canine otic isolates was determined quantitatively using a microtiter plate assay, and each isolate was classified as a strong, moderate, weak or nonbiofilm producer. Minimum biofilm eradication concentration (MBEC) of two ionophores (narasin and monensin) and three adjuvants (N-acetylcysteine (NAC), Tris-EDTA and disodium EDTA) were investigated spectrophotometrically (OD570nm ) and quantitatively (CFU/ml) against selected Staphylococcus and Pseudomonas biofilm cultures. Concurrently, minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of planktonic cultures were assessed. 16/20 of the S. pseudintermedius clinical isolates were weak biofilm producers. 19/20 P. aeruginosa clinical isolates produced biofilms and were distributed almost equally as weak, moderate and strong biofilm producers. While significant antibiofilm activity was observed, no MBEC was achieved with narasin or monensin. The MBEC for NAC ranged from 5,000-10,000 µg/ml and from 20,000-80,000 µg/ml against S. pseudintermedius and P. aeruginosa, respectively. Tris-EDTA eradicated P. aeruginosa biofilms at concentrations ranging from 6,000/1,900 to 12,000/3,800 µg/ml. The MBEC was up to 16-fold and eightfold higher than the MIC/MBC of NAC and Tris-EDTA, respectively. Disodium EDTA reduced biofilm growth of both strains at concentrations of 470 µg/ml and higher. It can be concluded that biofilm production is common in pathogens associated with canine OE. NAC and Tris-EDTA are effective antibiofilm agents in vitro that could be considered for the treatment of biofilm-associated OE in dogs.

Matched MeSH terms: Otitis Externa/microbiology; Otitis Externa/veterinary*

Fulltext Squamous cell carcinoma of the external auditory canal in a patient with non-resolving ear discharge

Zainuddin N, Abdullah O

Malays Fam Physician, 2015;10(2):52-4.

PMID: 27099662 MyJurnal

Discharging ear is a common symptom in the primary care and private general clinics. Most of the cases are treated with the antibiotic ear drops for otitis externa or otitis media. However, despite an adequate standard therapy, a malignant tumour can also be present with non-specific symptom such as ear discharge, especially in the case of persistent ear discharge. In this paper we have reported a case of an adult woman presented with non-resolving ear discharge who was treated repeatedly with antibiotic ear drop, which was later diagnosed as squamous cell carcinoma.

Matched MeSH terms: Otitis Externa

Fulltext Bruton's agammaglobulinaemia in a child presenting with cryptococcal empyema thoracis and periauricular pyogenic abscess

Wahab JA, Hanifah MJ, Choo KE

Singapore Med J, 1995 Dec;36(6):686-9.

PMID: 8781652

We describe here a case of cryptococcal empyema thoracis and periauricular pyogenic abscess in a child with Bruton's agammaglobulinaemia. The cryptococcal empyema thoracis was treated with intravenous amphotericin B and intravenous fluconazole for six weeks followed by oral fluconazole. The pyogenic periauricular abscess was surgically drained and treated with intravenous ceftazidime and cloxacillin for two weeks. He also received monthly intravenous immunoglobulin.

Matched MeSH terms: Otitis Externa/diagnosis*; Otitis Externa/therapy

Candida Skull Base Osteomyelitis: a Case Report and Literature Review

Krishnamoorthy M, Othman NAN, Hassan NEB, Hitam SB

Acta Medica (Hradec Kralove), 2020;63(2):82-85.

PMID: 32771074 DOI: 10.14712/18059694.2020.22

Skull base osteomyelitis (SBO) also commonly known as malignant otitis externa was first described by Meltzer and Kelemen in 1959. Prior to the advent of the antibiotic era, this disease carried a poor prognosis with significant morbidity. It often proved fatal with mortality rates as high as 50%. Commonly seen in the immunocompromised patients, diabetes mellitus is an important associated comorbidity in the pathophysiologic development of this disease. Treatment is instituted by medical therapy with surgery having a limited role. Surgical intervention has a limited role, for example, in fungal SBO. Such cases may require local debridement and intraoperative tissue biopsies for histopathologic confirmation. This is to demonstrate fungal invasion into the skull base, as well as to exclude other sinister differential diagnoses like squamous cell carcinoma of temporal bone. In this case report, we present a rare case of candida SBO and the literature review.

Matched MeSH terms: Otitis Externa

Fulltext Head and Neck Infections in Diabetic Patients

Sathasivam P

J Assoc Physicians India, 2018 Sep;66(9):84-88.

PMID: 31321937

Globally, the burden of diabetes is increasing very rapidly as is the diabetic related complications. Infections in diabetes mellitus are relatively more common and serious. Diabetic patients run the risk of acute metabolic decompensation during infections, and conversely patients with metabolic decompensation are at higher risk of certain invasive infections. Infections in diabetic patients result in extended hospital stays and additional financial burden.1 Medicine in modern world has seen tremendous advancements like newer generation of anti-diabetic drugs, modern insulin therapy, better intensive care facilities and more potent antibiotics. Despite all these advancements, infection still remains one of the major cause for increasing morbidity and mortality in diabetic patients2 . This article focuses on the common diabetes related infections in the Head and Neck region of the body. Some of the life threatening infections like malignant otitis externa and rhino-cerebral mucormycosis affect this region of body.

Matched MeSH terms: Otitis Externa

Fulltext Rare case of temporal bone carcinoma with intracranial extension

Kasim KS, Abdullah AB

Indian J Otolaryngol Head Neck Surg, 2012 Dec;64(4):397-8.

PMID: 24294589 DOI: 10.1007/s12070-011-0250-6

Temporal bone cancer, a relatively rare disease, accounting for less than 0.2% of all tumors of the head and neck and is associated with a poor outcome; often presents in a subtle manner, which may delay diagnosis. It should be suspected in any case of persistent otitis media or otitis externa that fails to improve with adequate treatment. Despite advances in operative technique and postoperative care, long-term survival remains poor). It includes cancers arising from pinna that spreads to the temporal bone, primary tumors of the external auditory canal (EAC), middle ear, mastoid, petrous apex, and metastatic lesions to the temporal bone. Here is a report on a case of temporal bone carcinoma presenting with right otalgia, otorrhea and facial paralysis. The patient was initially diagnosed as mastoiditis and later the clinical impression was revised to temporal bone carcinoma (undifferentiated type), based on the pathologic findings.

Matched MeSH terms: Otitis Externa

Antibacterial and antifungal properties of human cerumen

Lum CL, Jeyanthi S, Prepageran N, Vadivelu J, Raman R

J Laryngol Otol, 2009 Apr;123(4):375-8.

PMID: 18694532 DOI: 10.1017/S0022215108003307

To assess the antibacterial and antifungal properties of human cerumen by studying its effect on the growth of Staphylococcus aureus, Esherichia coli, Pseudomonas aeruginosa and Candida albicans.

Matched MeSH terms: Otitis Externa/prevention & control

In vitro antimicrobial activity of narasin and monensin in combination with adjuvants against pathogens associated with canine otitis externa

Chan WY, Hickey EE, Khazandi M, Page SW, Trott DJ, Hill PB

Vet Dermatol, 2020 Apr;31(2):138-145.

PMID: 31710159 DOI: 10.1111/vde.12803

BACKGROUND: The emergence of antimicrobial resistance represents a serious human and animal health risk. Good antimicrobial stewardship is essential to prolong the lifespan of existing antibiotics, and new strategies are required to combat infections in man and animals.

HYPOTHESIS/OBJECTIVES: To determine the in vitro interaction of ionophores (narasin or monensin) with antimicrobial adjuvants (N-acetylcysteine (NAC), Tris-EDTA or disodium EDTA) against bacterial strains representing pathogens associated with canine otitis externa (OE).

ANIMAL/ISOLATES: American Type Culture Collection (ATCC) strains Staphylococcus aureus 29213, Pseudomonas aeruginosa 27853 and P. aeruginosa biofilm producer PAO1, and a clinical isolate of Proteus mirabilis from a case of canine OE were tested.

METHODS AND MATERIALS: A 2D microdilution checkerboard method was used, allowing calculation of fractional inhibitory concentration index (FICI), dose reduction index (DRI) and plotting of isobolograms.

RESULTS: The combination of narasin with either Tris-EDTA or disodium EDTA produced additive effects (FICI = 0.75) against P. aeruginosa ATCC 27853 and P. aeruginosa biofilm producer ATCC PAO1. An additive effect (FICI = 0.53-0.75) was found against S. aureus ATCC 29213 when narasin or monensin were combined with NAC. The highest DRI (32-fold) was found with monensin/NAC where the MIC of monensin was reduced from 4 to 0.125 μg/mL.

CONCLUSIONS AND CLINICAL IMPORTANCE: The combination of narasin with Tris-EDTA or disodium EDTA is a promising strategy to inhibit the intrinsic resistance elements of Gram-negative bacteria. These novel combinations potentially could be useful as a multimodal approach to treat mixed infections in canine OE.

Matched MeSH terms: Otitis Externa

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