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Necrotizing otitis
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- This condition refers to an infection of the external ear canal, often occurring in patients with weakened immune systems (i.e., compromised body defenses). The ear has two canals, an external and an internal one.
- A drum like structure called the tympanic membrane, and the middle ear, separate the two canals. Malignant Otitis Externa (MOE) starts in the external canal, but can spread to the middle ear and the surrounding bones and brain structures.
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- Pain around the ear
- Movement of the ear is very painful
- Discharge of yellowish-greenish thick liquid from the affected ear
- Redness and tenderness around the ear and the surrounding tissue
- Fever if infection is severe
- Neurological symptoms (i.e., confusion, headache, balance problems, weakness or paralysis on one side) if it spreads inside the brain and skull.
- Wisdom teeth pain
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- Bacteria such as Pseudomonas aeruginosa (normally lives in the external canal), Staphylococcus aureus, and enterobacter species are common causes.
- Fungi such as Aspergillus and yeast can also cause MOE.
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- A physical exam of the ear and a general exam must be done. The ear and surrounding area is observed and palpated. The physician will need to look inside the ear using an otoscope. Cultures or a sample of the discharge must be sent to laboratory for analysis.
- Blood analysis is done if the patient is very sick (i.e., elderly, diabetic, has other severe illnesses, high fever, or confusion). CAT scan or other X-Rays may be needed if the physician suspects a spread of the infection to the skull and the brain.
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- Elderly people with diabetes
- Swimmers, especially in the summer time
- Use of a hearing aid
- Immunocompromised individuals, i.e., patients with AIDS, cancer, poorly controlled diabetics, those with liver or kidney failure, patients on chemotherapy, and drug addicts
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- If there is fever and the patient appears very sick, he or she is admitted to the hospital for intravenous antibiotics, further work up, and possible surgical cleaning or drainage of the ear and affected areas.
- In the case of a mild infection, the patient will receive painkillers such as Tylenol (2 tablets extra strength every six hours as needed) and antibiotic drops such as Cortisporin (3-4 drops) every eight hours for one week or until the laboratory results become available.
- In cases where there is potential
for the infection to worsen, orally taken antibiotics are
given for up to 14 days with a follow up visit.
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If you have ear pain, discharge, or fever, seek medical attention immediately, especially if you are elderly or have some other underlying disease such as diabetes.
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- Ruptured tympanic membrane. Less severe, thus it is a non-malignant form of an external ear infection.
- Middle ear infection.
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