Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute for Cardiovascular Diseases "Dedinje", Belgrade, Serbia.
Ear Nose Throat J. 2023 Sep;102(9_suppl):31S-34S. doi: 10.1177/01455613231189219. Epub 2023 Jul 28.
We present a case of a 58-year-old male with type II diabetes managed with metformin and insulin, who presented to the clinic with left chronic otitis media, persistent drainage, a stenotic meatus, and a prior history of 3 canal wall-down mastoidectomies and antibiotic therapy. A revision tympanoplasty with mastoidectomy was performed, and during the postoperative period, the patient had persistent pain and otorrhea, which were managed with opioids and several courses of antibiotic therapy. After symptoms persisted, imaging and culture ultimately led to the diagnosis of fungal skull base osteomyelitis, which was eventually treated successfully. While these complications are rare, their likelihood is increased with treatment delay and in the immunocompromised patient. Close management of immunocompromised patients, including diabetic patients, is vital in identifying complications early to aid in timely diagnosis and treatment to lead to the best possible outcome.
我们报告一例 58 岁男性病例，该患者患有 II 型糖尿病，使用二甲双胍和胰岛素治疗，因左侧慢性中耳炎、持续排液、狭窄耳道就诊，并有 3 次经耳道后壁乳突切除术和抗生素治疗病史。患者行翻修鼓室成形术和乳突切除术，术后患者持续疼痛和耳漏，经阿片类药物和数轮抗生素治疗后得到控制。但症状持续存在，影像学和培养最终导致真菌性颅底骨髓炎的诊断，最终成功治疗。尽管这些并发症罕见，但治疗延迟和免疫功能低下的患者会增加其发生的可能性。密切管理免疫功能低下的患者，包括糖尿病患者，对于早期识别并发症至关重要，有助于及时诊断和治疗，从而获得最佳结果。
