@article{3118734,
    title = "A Different Era for Malignant Otitis Externa: The Non-Diabetic and Non-Immunocompromised Patients",
    author = "Sideris, G. and Latzonis, J. and Avgeri, C. and Malamas, V. and Delides, A. and Nikolopoulos, T.",
    journal = "Journal of International Advanced Otology",
    year = "2022",
    volume = "18",
    number = "1",
    pages = "20-24",
    publisher = "AVES Publishing Co.",
    doi = "10.5152/iao.2022.21313",
    keywords = "antiinfective agent, aged;  external otitis;  human;  microbiology;  Pseudomonas aeruginosa;  very elderly, Aged;  Aged, 80 and over;  Anti-Bacterial Agents;  Humans;  Otitis Externa;  Pseudomonas aeruginosa",
    abstract = "BACKGROUND: Τo investigate the differences in regard to the clinical, laboratory, and imaging findings as well as the treatment course between diabetic and non-diabetic, non-immunocompromised patients with malignant otitis externa. METHODS: A total of 36 hospitalized patients diagnosed with malignant otitis externa between January 2011 and December 2020 were divided into 2 groups according to their medical history, blood glucose, and glycated hemoglobin levels. RESULTS: Thirty-two patients were diabetic (group A) and 4 were non-diabetic, non-immunocompromised (group B). Otalgia was present in all patients (100%), followed by otorrhoea (67%) and edema (64%). Polyps were present in 18 patients (50%). Pseudomonas aeruginosa was isolated in 16 out of 25 positive cultures (64%). Four patients of group A and none of group B underwent surgery. Five patients of group A and none of group B had at least 1 cranial nerve involvement. The mean age was 77.22 ± 8.17 for group A and 47.25 ± 3.59 for group B (P < .001). No statistical significance was observed in regards to major symptoms, inflammatory markers (white blood cell, C-reactive protein, and erythrocyte sedimenta-tion rate), positive imaging, and microbiological findings between the 2 groups. The average days of hospitalization were 42.41 ± 31.06 for group A and 10.25 ± 2.63 for group B (P < .049). Four diabetic patients died. CONCLUSION: Non-diabetic, non-immunocompromised adult patients with malignant otitis externa had a better response to antibiotic therapy and a shorter length of hospitalization. A high clinical suspicion for malignant otitis externa should always raise in cases of otitis externa that fail to respond in a topic and/or oral antibiotic treatment for more than a week. © 2022, AVES. All rights reserved."
}