How is malignant otitis externa diagnosed?

Mandatory laboratory tests include an erythrocyte sedimentation rate (ESR), white and red blood cell counts, glucose and creatinine levels, and culture of ear secretions. The ESR is typically elevated in necrotizing external otitis; therefore, it is a useful indicator of treatment response.

What is malignant otitis externa?

Malignant external otitis (MEO) is an infection that affects the external auditory canal and temporal bone. The causative organism is usually Pseudomonas aeruginosa, and the disease commonly manifests in elderly patients with diabetes.

How would you describe otitis externa on a physical exam?

The key physical finding of OE is pain upon palpation of the tragus (anterior to ear canal) or application of traction to the pinna (the hallmark of OE). Examination reveals erythema, edema, and narrowing of the external auditory canal (EAC), and a purulent or serous discharge may be noted (see the image below).

What is malignant otitis externa NHS?

Malignant otitis externa is a disorder that involves infection of and damage to the bones of the ear canal and at the base of the skull. Malignant otitis externa is caused Page 6 6 For implementation from 1 April 2019 by the spread of an outer ear infection (otitis externa) also called swimmer’s ear.

Is malignant otitis externa same as mastoiditis?

Otitis Media is an infection of the middle ear. Patients typically present with otalgia, otorrhea, fever, irritability, anorexia, and hearing loss. Mastoiditis is an infection of the mastoid bone. Patients present with pain, swelling, and erythema over the mastoid bone.

What is differential diagnosis otitis externa?

Ear canal trauma. Ear canal carcinoma. Otitis media with a perforation or ventilation tube present. Chondritis.

How can you tell the difference between media and otitis externa?

The main symptom of otitis is pain, whether it is otitis externa or otitis media. If it is otitis externa, the pain may increase when the earlobe is pulled, which is generally not the case for otitis media. In young children, the pain can be expressed in these different signs, the child: frequently pulls on the ear.

Is malignant otitis externa curable?

Antipseudomonal antimicrobials are the mainstay of therapy for malignant external otitis. Prior to the development of systemic agents, the mortality from this disease approximated 50% with frequent recurrences. The cure rate has increased to 90% with the introduction of fluroquinolones.

Is malignant otitis externa painful?

The symptoms of malignant otitis externa are easily recognizable. They can include: persistent and foul-smelling yellow or green drainage from the ear. ear pain that gets worse when moving the head.

What are the symptoms of malignant otitis externa?


  • Ongoing drainage from the ear that is yellow or green and smells bad.
  • Ear pain deep inside the ear. Pain may get worse when you move your head.
  • Hearing loss.
  • Itching of the ear or ear canal.
  • Fever.
  • Trouble swallowing.
  • Weakness in the muscles of the face.