Malignant otitis externa and diabetes: Report of four cases

Malignant otitis externa (MOE) is an uncommon infective but potentially fat al entity caused by Pseudomonas aeruginosa. It involves almost exclusively advanced aged diabetic patients. We report here four cases diagnosed at our hospital during the last 7 years. Clinical manifestations included otalgia , purulent otorrhoea; involvement of different cranial nerves and bony dest ruction; one patient died because of bronchoaspiration and two are alive bu t with sequelae. MOE should be suspected in every diabetic patient with oti tis which goes unresolved with the usual antibiotic therapy. On the other h and, facial palsy should not always be attributed to a diabetic mononeuropa thy and the presence of MOE should be ruled out when otitis coexists or pre cedes it.