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坏死性外耳道炎后鼻咽部及颞骨脓肿:一例报告

Nasopharyngeal and temporal bone abscess following necrotizing otitis externa: a case report.

作者信息

Alharthi Ahmad S, Almalki Zohour A, Alnafie Johara A, Althobaiti Hazem K, Ibrahim Mohamed M

机构信息

Department of Otolaryngology-Head & Neck Surgery, Alhada Armed Forces Hospital, Alhada, Taif City 26792, Saudi Arabia.

College of Medicine and Surgery, Taif University, Alhawiyah, Taif City 26516, Saudi Arabia.

出版信息

J Surg Case Rep. 2024 Sep 5;2024(9):rjae565. doi: 10.1093/jscr/rjae565. eCollection 2024 Sep.

Abstract

Necrotizing otitis externa (NOE) is a severe infection primarily affecting the external auditory canal, seen mainly in immunocompromised individuals as patients with diabetes mellitus (DM). This case report highlights unusual complications of NOE: temporal bone and nasopharyngeal abscesses. These complications underscore the severity of NOE, particularly when caused by rare pathogens such as Klebsiella species. We detail the case of a 70-year-old male with uncontrolled DM who presented with severe right ear pain, purulent discharge, and significant postauricular swelling. Laboratory investigations revealed elevated inflammatory markers and poorly controlled diabetes. Cultures confirmed , and imaging showed diffuse edema and abscess formation in the temporal bone and nasopharynx. The patient was treated with intravenous Ceftazidime and ciprofloxacin for 6 weeks, followed by oral ciprofloxacin. Effective management of NOE necessitates a comprehensive, multidisciplinary approach. Early intervention, regular monitoring, and imaging are critical for promptly detecting and managing complications.

摘要

坏死性外耳道炎(NOE)是一种主要影响外耳道的严重感染,主要见于免疫功能低下的个体,如糖尿病(DM)患者。本病例报告突出了NOE的不寻常并发症:颞骨和鼻咽部脓肿。这些并发症强调了NOE的严重性,特别是当由罕见病原体如克雷伯菌属引起时。我们详细介绍了一名70岁男性糖尿病控制不佳患者的病例,该患者出现严重的右耳疼痛、脓性分泌物和明显的耳后肿胀。实验室检查显示炎症标志物升高且糖尿病控制不佳。培养结果证实了[此处原文缺失相关内容],影像学显示颞骨和鼻咽部弥漫性水肿和脓肿形成。患者接受了静脉注射头孢他啶和环丙沙星治疗6周,随后口服环丙沙星。NOE的有效管理需要全面、多学科的方法。早期干预、定期监测和影像学检查对于及时发现和处理并发症至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1e02/11374375/c28b6b3a919b/rjae565f1.jpg

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