Wolff L J
Department of Pediatrics, Doernbecher Memorial Hospital for Children, Oregon Health Sciences University, Portland 97201.
Pediatrics. 1989 Nov;84(5):882-5.
In three children who were receiving acute lymphoblastic leukemia induction therapy and were severely neutropenic, necrotizing otitis externa developed. Two patients had a probing maneuver to their ear canal. Pseudomonas aeruginosa was isolated in heavy growth from the external canal of three patients and other tissues of one patient. Staphylococcus aureus was cultured from the ear canal and tissues of one patient and Streptococcus faecalis from the ear canal of another patient. Necrotizing otitis externa resolved in two patients after 2 weeks of intravenous antibiotics, debridement, and resolution of neutropenia. One patient required prolonged intravenous antibiotics and several surgical procedures. The occurrence of necrotizing otitis externa in children with acute lymphoblastic leukemia and severe neutropenia, the association of Gram-positive cocci with necrotizing otitis externa, and the importance of protecting anatomic barriers like the external ear canal in immunocompromised patients are emphasized.
在3名接受急性淋巴细胞白血病诱导治疗且严重中性粒细胞减少的儿童中，发生了坏死性外耳道炎。2例患者耳道进行了探查操作。从3例患者的外耳道以及1例患者的其他组织中大量分离出铜绿假单胞菌。从1例患者的耳道和组织中培养出金黄色葡萄球菌，从另1例患者的耳道中培养出粪肠球菌。2例患者在接受2周静脉抗生素治疗、清创及中性粒细胞减少症缓解后，坏死性外耳道炎得到缓解。1例患者需要长期静脉使用抗生素并接受多次外科手术。强调了急性淋巴细胞白血病和严重中性粒细胞减少症患儿中坏死性外耳道炎的发生、革兰氏阳性球菌与坏死性外耳道炎的关联，以及在免疫功能低下患者中保护外耳道等解剖屏障的重要性。
