Tabashiri Arefeh, Allahverdi Nazhand Hadi, Fathy Mobin, Mortazavi Seyed Mohammad, Javandoust Gharehbagh Farid, Haghighi-Morad Maryam, Mokhtarinejad Farhad, Alavi Darazam Ilad
School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
BMC Infect Dis. 2025 Feb 26;25(1):277. doi: 10.1186/s12879-025-10637-8.
Malignant otitis externa (MOE) is a life-threatening infection of the external auditory canal and temporal bone.
This study is designed to identify the clinical features, predisposing factors, radiological findings, complications, diagnoses, and management of MOE patients.
Retrospective cross-sectional study.
Loghman-e-Hakim Hospital, Tehran, Iran.
The study included 40 patients diagnosed with MOE from 2011 to 2023. The data extracted from medical records included demographic data, clinical signs and symptoms, radiological findings, laboratory data, predisposing factors, complications, treatments, and outcomes. Out of 37 patients, 21 were followed up.
The study found that the mean age of patients was 62.24 ± 11.44 years, with 62.2% being male. Otalgia and otorrhea were the most commonly reported symptoms, and mastoiditis was the most common radiological finding. Bone erosions and osteomyelitis were other important complications. Vascular complications were also observed in 7 patients. The study also found that most patients had underlying conditions such as diabetes mellitus, hypertension, ischemic heart disease, and renal disease. One patient passed away during hospitalization, while others improved and were discharged. Then, at follow-up, 11 patients died, mainly due to the progression of underlying disorders including cardiac, and renal manifestations.
Based on our findings, although MOE most commonly occurs in poorly-controlled diabetic or immunocompromised patients, it can also occur in individuals without known conditions. Furthermore, increasing the age and severity of DM could lead to more complications. In terms of medical therapy, coverage of gram-positive bacteria and an antipseudomonal regimen would be an effective treatment.
恶性外耳道炎（MOE）是一种危及生命的外耳道和颞骨感染。
本研究旨在确定MOE患者的临床特征、易感因素、影像学表现、并发症、诊断和治疗方法。
回顾性横断面研究。
伊朗德黑兰的洛格曼-哈基姆医院。
该研究纳入了2011年至2023年期间诊断为MOE的40例患者。从病历中提取的数据包括人口统计学数据、临床体征和症状、影像学表现、实验室数据、易感因素、并发症、治疗方法和治疗结果。在37例患者中，21例进行了随访。
研究发现，患者的平均年龄为62.24±11.44岁，男性占62.2%。耳痛和耳漏是最常报告的症状，乳突炎是最常见的影像学表现。骨质侵蚀和骨髓炎是其他重要并发症。7例患者还出现了血管并发症。研究还发现，大多数患者有潜在疾病，如糖尿病、高血压、缺血性心脏病和肾病。1例患者在住院期间死亡，其他患者病情好转并出院。随后，在随访中，11例患者死亡，主要是由于包括心脏和肾脏表现在内的潜在疾病进展。
根据我们的研究结果，虽然MOE最常见于糖尿病控制不佳或免疫功能低下的患者，但也可能发生在无已知疾病的个体中。此外，糖尿病年龄增加和病情严重程度增加可能导致更多并发症。在药物治疗方面，覆盖革兰氏阳性菌和抗假单胞菌方案将是一种有效的治疗方法。
