恶性外耳道炎：不断变化的治疗模式。
Malignant external otitis: The shifting treatment paradigm.
作者信息
Carlton Daniel A, Perez Enrique E, Smouha Eric E
机构信息
Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Otolaryngology - Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
出版信息
Am J Otolaryngol. 2018 Jan-Feb;39(1):41-45. doi: 10.1016/j.amjoto.2017.05.010. Epub 2017 May 25.
IMPORTANCE
Malignant external otitis (MEO) is an aggressive infection occurring in immunocompromised hosts. Increasing antimicrobial resistance is making the disease more difficult to treat.
OBJECTIVE
Determine if there has been a shift in the microbiology and outcomes of MEO.
DESIGN
A retrospective case series at a tertiary care institution.
SETTING
Inpatient and outpatient tertiary care hospital.
PARTICIPANTS
12 cases of recent MEO were reviewed.
MAIN OUTCOMES AND MEASURES
The primary outcome was progression of disease. Secondary outcomes were drug resistance and complications of MEO.
RESULTS
Only 4 patients were cured of MEO. Four patients expired during the study period and at least one of these deaths was a direct result of the MEO. 7 patients developed Cranial nerve palsies, and 3 patients developed abscesses.
CONCLUSIONS
Select cases of MEO now require multi-drug and long-term parenteral antibiotic therapy with extended hospital stays.
重要性
恶性外耳道炎（MEO）是一种发生于免疫功能低下宿主的侵袭性感染。抗菌药物耐药性不断增加，使得该疾病更难治疗。
目的
确定MEO的微生物学及治疗结果是否发生了变化。
设计
在一家三级医疗机构进行的回顾性病例系列研究。
地点
三级护理住院和门诊医院。
参与者
对12例近期MEO病例进行了回顾。
主要结局和衡量指标
主要结局为疾病进展。次要结局为MEO的耐药性和并发症。
结果
仅4例MEO患者治愈。4例患者在研究期间死亡，其中至少1例死亡是MEO的直接结果。7例患者出现颅神经麻痹，3例患者出现脓肿。
结论
现在，部分MEO病例需要多药联合、长期肠外抗生素治疗并延长住院时间。
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