Malignant otitis externa - Revision history

Rossdonaldson1: /* Evaluation */

2022-01-06T05:54:47Z

Evaluation

← Older revision		Revision as of 05:54, 6 January 2022
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	==Evaluation==		==Evaluation==
			[[File:PMC3292638 13244 2011 126 Fig5 HTML.png\|thumb\|Malignant external otitis. Axial CT scan in bone window demonstrates destruction of mastoid segment of petrous bone. There were also subtle cortical destructions visible in tympanic bone.]]
	*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>		*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>
	**Most authors support CT initially, but CT fails to diagnose early osteomyelitis since 30% bone destruction needed for detection		**Most authors support CT initially, but CT fails to diagnose early osteomyelitis since 30% bone destruction needed for detection

2019-09-30T21:09:04Z

Clinical Features

← Older revision		Revision as of 21:09, 30 September 2019
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	*Granulation tissue often seen in the ear canal floor		*Granulation tissue often seen in the ear canal floor
	*Facial nerve often first CN involved<ref>Pfaff JA, Moore GP: Otolaryngology, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, Ch 72.</ref>		*Facial nerve often first CN involved<ref>Pfaff JA, Moore GP: Otolaryngology, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, Ch 72.</ref>
	*CN IX, X, or XI involvement		*[[cranial nerve palsies\|CN IX, X, or XI involvement]]
	*Trismus		*Trismus

	===Pediatrics===		===Pediatrics===
	*More rapidly progressive than in adults		*More rapidly progressive than in adults
	**[[Fever]], leukocytosis, bacteremia/[[sepsis]]		**[[Fever]], [[leukocytosis]], bacteremia/[[sepsis]]
	*TM, middle ear, and facial nerve more likely to be affected		*TM, middle ear, and facial nerve more likely to be affected

2019-08-16T02:15:58Z

Background

← Older revision		Revision as of 02:15, 16 August 2019
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	==Background==		==Background==
			[[File:Gray907.png\|thumb\|Ear anatomy]]
	*Life-threatening infection of external ear/canal, soft tissue, +/- spread to skull base		*Life-threatening infection of external ear/canal, soft tissue, +/- spread to skull base
	*Diabetes and immunosuppression are main risk factors		*Diabetes and immunosuppression are main risk factors

2017-05-31T02:12:51Z

Text replacement - "OR" to "'''OR'''"

← Older revision		Revision as of 02:12, 31 May 2017
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	==Management==		==Management==
	===Adults===		===Adults===
	*[[Antipseudomonal cephalosporin]] OR [[fluoroquinolone]]		*[[Antipseudomonal cephalosporin]] '''OR''' [[fluoroquinolone]]

	===Peds===		===Peds===
	*[[Imipenem]] OR ([[aminoglycoside]] + [[antipseudomonal penicillin]])		*[[Imipenem]] '''OR''' ([[aminoglycoside]] + [[antipseudomonal penicillin]])

	==Disposition==		==Disposition==

2016-07-22T13:06:06Z

Text replacement - "==Diagnosis==" to "==Evaluation=="

← Older revision		Revision as of 13:06, 22 July 2016
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	{{Ear DDX}}		{{Ear DDX}}

	==~~Diagnosis~~==		==Evaluation==
	*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>		*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>
	**Most authors support CT initially, but CT fails to diagnose early osteomyelitis since 30% bone destruction needed for detection		**Most authors support CT initially, but CT fails to diagnose early osteomyelitis since 30% bone destruction needed for detection

2016-07-14T00:05:40Z

Disposition

← Older revision		Revision as of 00:05, 14 July 2016
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	==Disposition==		==Disposition==
	*Contact ENT for disposition decision; early infection may be managed as ~~outpt~~		*Contact ENT for disposition decision; early infection may be managed as outpatient

	==Complications==		==Complications==

2016-07-14T00:05:25Z

Diagnosis

← Older revision		Revision as of 00:05, 14 July 2016
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	==Diagnosis==		==Diagnosis==
	*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>		*Imaging<ref>Nussenbaum B et Al. Malignant Otitis Externa Workup. Medscape, Jul 14 2015. http://emedicine.medscape.com/article/845525-workup#c4</ref>
	**Most authors support CT initially, but CT fails to dx early osteomyelitis since 30% bone destruction needed for detection		**Most authors support CT initially, but CT fails to diagnose early osteomyelitis since 30% bone destruction needed for detection
	**MRI more sensitive for intracranial complications		**MRI more sensitive for intracranial complications
	*Labs		*Labs

2016-07-08T00:39:51Z

Text replacement - "==Treatment==" to "==Management=="

← Older revision		Revision as of 00:39, 8 July 2016
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	***However, not required for diagnosis<ref>Hosmer, K: Ear Disorders, in Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM (eds): Emergency Medicine, A Comprehensive Study Guide, ed 8. New York, McGraw-Hill, 2016, Ch 242:p 1581-2.</ref>		***However, not required for diagnosis<ref>Hosmer, K: Ear Disorders, in Tintinalli JE, Stapczynski JS, Ma OJ, Yealy DM, Meckler GD, Cline DM (eds): Emergency Medicine, A Comprehensive Study Guide, ed 8. New York, McGraw-Hill, 2016, Ch 242:p 1581-2.</ref>

	==~~Treatment~~==		==Management==
	===Adults===		===Adults===
	*[[Antipseudomonal cephalosporin]] OR [[fluoroquinolone]]		*[[Antipseudomonal cephalosporin]] OR [[fluoroquinolone]]

2016-06-27T18:06:31Z

Text replacement - "==Source==" to "==References== <references/>"

2016-06-27T10:02:28Z

Text replacement - "*Tintinalli" to ""