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Clinical and Current Microbiological Profile with Changing Antibiotic Sensitivity in Malignant Otitis Externa

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Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Malignant otitis externa (MOE) is a rare and fatal condition affecting temporal bone. It is also known as skull base osteomyelitis and is a rapidly progressive condition. This retrospective study evaluates the clinical, haematological, microbiological profile and management of malignant otitis externa in a tertiary care hospital and literature review. A retrospective review of 79 patients diagnosed with Malignant Otitis Externa from January 2015 to June 2021 was analyzed. History and Clinical findings, Imaging, Bacteriology, Random blood sugar on admission, Erythrocyte Sedimentation rate, HbA1C level, Biopsy of the granulation tissue from Externa auditory canal, cranial nerve involvement, duration of hospital stay, and treatment outcomes were analyzed. Out of 79 patients, otorrhea, otalgia, EAC oedema, and granulation were the most common findings. Facial nerve paralysis was found in 20 patients (25.3%) and multiple cranial nerve paralysis in 5 patients (6.3%). Uncontrolled diabetes mellitus and older age have increased duration of hospital stay, while cranial nerve paralysis did not affect this duration. Six different microorganisms were isolated. Pseudomonas aeruginosa was the most common organism cultured. Ciprofloxacin resistance was detected in 79% of cases. Amikacin, Cefaperazone-Sulbactam, and Piperacillin were the most sensitive antibiotics for gram negative organisms in our study. This study reviews the current microbiological profile and shows the need for higher-end antibiotics to treat MOE in present times. Early diagnosis, aggressive control of diabetes mellitus, and long duration culture-sensitive antibiotic therapy with regular monitoring are essential to reducing morbidity and mortality due to MOE.

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Funding

This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.

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Authors and Affiliations

  1. Department of Otorhinolaryngology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, 605 006, India

    Raghul Sekar, Kalaiarasi Raja, Sivaraman Ganesan, Arun Alexander & Sunil Kumar Saxena

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  1. Raghul Sekar
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  2. Kalaiarasi Raja
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  3. Sivaraman Ganesan
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  4. Arun Alexander
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  5. Sunil Kumar Saxena
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Contributions

Kalaiarasi Raja and Sivaraman Ganesan: Conceptualized, Collected data,; Raghul Sekar: Wrote the article, Analysed data; Kalaiarasi Raja, Sunil Saxena, Arun Alexander: Revised article. All authors contributed to the study conception and design. The first draft of the manuscript was written by [Dr Raghul Sekar] and all authors commented on previous versions of the manuscript. All authors read and approved the final manuscript.

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Correspondence to Kalaiarasi Raja.

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This study was performed in line with the principles of the Declaration of Helsinki. Our Institute Research Ethics Committee has confirmed that no ethical approval was required.

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Sekar, R., Raja, K., Ganesan, S. et al. Clinical and Current Microbiological Profile with Changing Antibiotic Sensitivity in Malignant Otitis Externa. Indian J Otolaryngol Head Neck Surg 74 (Suppl 3), 4422–4427 (2022). https://doi.org/10.1007/s12070-021-03068-9

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  • DOI: https://doi.org/10.1007/s12070-021-03068-9

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