Diseases of The Ear
An old diabetic male presen.ted with rapidly spreadi",g infection of the external auditory canal with involvement of the bone and presence of granulation tissue. The drug of choice for this condition is: [AIIMS May. 12]
|C||Second generation cephalosporin|
Rapidly spreading infection of external auditory canal, seen in diabetic patient with involvem~nt of bone and presence of cgranu/citiOn tiSsue point towards malignant otitis externa as the diagnosis.
• Includes correction of immunosuppression (when possible), local treatment of the auditory canal, long-term systemic antibiotic therapy, and in selected patients, surgery:
• In all cases, the external ear canal is cleansed and a biopsy specimen of the granulation tissue sent for culture.
• IV antibiotics is directed against the offending organism.
• For Pseudomonas aeruginosa, the most common pathogen, the regimen involves an antipseudomonal penicillin or cephalosporin (3rd generation piperacillin or ceftazidime) with an aminoglycoside. A f1uoroquinolone _ antibiotic can be used in place of the aminoglycoside.
• Ear drops containing antipseudomonal antibotic e.g. ciproflaxacin plus a glucocorticoid is also used.
• Early cases can be managed with oral and otic f1uoroquinolones only.
• Extensive surgical debridement once an important part of the treatment is now rarely needed.