H60.20

Clinical Causes: Chronic bacterial infections, most commonly Pseudomonas aeruginosa Weakened immune system due to diabetes, HIV/AIDS, or chemotherapy Prolonged moisture or trauma to the ear canal Inadequate treatment of initial otitis externa Use of hearing aids or ear tubes that cause trauma or harbor bacteria

Key Symptoms: Persistent ear pain, often severe and worsening over time Discharge from the ear that may be foul-smelling or bloody Itching or a feeling of fullness in the affected ear Swelling or redness around the ear canal Hearing loss or muffled hearing Facial nerve weakness or paralysis in advanced cases Fever and malaise in some instances

Diagnosis Path: Diagnosis typically involves a combination of medical history, physical examination, and laboratory testing. An otoscopic examination allows healthcare providers to assess the ear canal for swelling, redness, discharge, and tissue destruction. Cultures of ear discharge help identify the causative bacteria. Imaging studies such as computed tomography (CT) scans may be performed to evaluate the extent of bone involvement and to detect potential spread to adjacent structures. Blood tests may also be used to assess for infection or underlying conditions like diabetes.

Treatment Protocols: Treatment of malignant otitis externa usually involves a combination of aggressive antibiotic therapy, often administered intravenously, to combat the bacterial infection. The antibiotics are typically targeted based on culture results. Managing underlying conditions, such as controlling blood sugar levels in diabetics, is essential for effective treatment. In some cases, surgical intervention may be necessary to remove infected tissue or to manage complications. Patients require close monitoring to ensure the infection resolves and to prevent potential complications, including osteomyelitis or intracranial spread.