Malignant external otitis complicated by spinal cord compression: Case report

INTRODUCTION: Malignant otitis externa is a life-threatening infectious pathology that occurs mainly in diabetic patients; in a picture of otorrhea, with facial paralysis. We report the case of a necrotizing otitis externa, treated with antibiotics, which was complicated a few months later by spinal compression. OBSERVATION: This is the case of a 60-year-old patient, diabetic, who presented a painful otorrhea associated to left facial palsy. The diagnosis of necrotizing otitis externa was retained after performing a CT scan of the temporal bone. 6 months after medical treatment, the patient became has been complicated by tetraparesis with respiratory distress. DISCUSSION: Necrotizing otitis externa is an osteitis of the base of the skull, which occurs in the diabetic patient and which starts in the external ear and spreads by contiguity after infection of the temporal bone. It represented clinically by otalgia and purulent otorrhea. The role of imaging is to confirm the involvement and to specify the extension of the lesions. CT scan is useful to evaluate the bone involvement. MRI is the examination of choice for the study of soft tissues and is essential in advanced forms. Its treatment is based on antibiotic therapy for a minimum of 6 weeks. CONCLUSION: OEM is an infection occurring in elderly and diabetic patients. Imaging allows to confirm the diagnosis and to carry out the assessment of extension; but also has a great interest in the follow-up of these immunocompromised patients who are subject to complications with insidious evolution