Hostname: page-component-8448b6f56d-m8qmq Total loading time: 0 Render date: 2024-04-24T16:10:53.926Z Has data issue: false hasContentIssue false
  • English
  • Français

Malignant otitis externa in HIV and AIDS

Published online by Cambridge University Press:  29 June 2007

J. D. Hern ,
J. Almeyda ,
D. M. Thomas ,
J. Main  and
K. S. Patel
J. D. Hern*
Affiliation:
Department of Otolaryngology, St Mary's Hospital, London, UK
J. Almeyda
Affiliation:
Department of Otolaryngology, St Mary's Hospital, London, UK
D. M. Thomas
Affiliation:
Department of Otolaryngology, St Mary's Hospital, London, UK
J. Main
Affiliation:
Infections Diseases, St Mary's Hospital, London, UK
K. S. Patel
Affiliation:
Department of Otolaryngology, St Mary's Hospital, London, UK
*
Address for correspondence: Mr J. D. Hern, F.R.C.S., Department of Otoalryngology and Head and Neck Surgery, St. Mary's Hospital, Praed Street, Paddigton, London W2 1NY. Fax: 0171 725 1847.
Get access Rights & Permissions [Opens in a new window]

Abstract

Malignant otitis externa is a necrotising infection of the external ear canal which may spread to include the mastoid and petrous parts of the temporal bone, leading to skull base osteomyelitis. It is almost exclusively caused by infection with Pseudomonas aeruginosa, and usually occurs in elderly non-insulin-dependent diabetic patients. However isolated cases have been reported in a small number of non-diabetic patients, particularly in children who are immunocompromised due to malignancy, malnutrition and severe anaemia. In 1984 a case of malignant otitis externa was reported in a child with an acquired immunodeficiency syndrome (AIDS)-like illness, prior to identification of the human immunodeficiency virus (HIV). Since that time further sporadic cases of this invasive infection have been reported in HIV and AIDS. We present two further cases and also a review of the current literature.

Keywords

Otitis externa, malignantAcquired immunodeficiency syndromeHIVPseudomonas aeruginosa
Type
Clinical Records
Information
The Journal of Laryngology & Otology , Volume 110 , Issue 8 , August 1996 , pp. 770 - 775
Copyright
Copyright © JLO (1984) Limited 1996

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Bayardelle, P., Jolivet-Granger, M., Laochelle, D. (1982) Staphylococcal malignant otitis externa. Canadian Medical Association Journal 126: 155–156.Google Scholar
Bodey, G. P., Jadeja, L., Elting, L. (1985) Pseudomonas aeruginosa bacteraemia: retrospective analysis of AID episodes. Archives of Internal Medicine 145: 1621–1629.CrossRefGoogle Scholar
Caruso, V. F., Griffiths, C. M., Bailey, B. J. (1977) Malignant external otitis. Texas Medicine 73: 106–113.Google ScholarPubMed
Chandler, J. R. (1968) Malignant otitis externa. Laryngoscope 78: 1257–1294.CrossRefGoogle Scholar
Chandler, J. R. (1974) Malignant external otitis and facial paralysis. Otolaryngologic Clinics of North America 7: 375–383.CrossRefGoogle ScholarPubMed
Coser, P. L., Stamm, A. E. C., Lobo, R. C., Pinto, J. A. (1980) Malignant otitis externa in infants. Laryngoscope 90: 312–315.CrossRefGoogle ScholarPubMed
Cunningham, M. J., Yu, V. L., Turner, J., Curtin, H. D. (1988) Necrotising otitis externa due to Aspergillusfumigatus in an immunocompetent patient. Archives of Otolaryngology, Head and Neck Surgery 114: 554–556.CrossRefGoogle Scholar
Daniels, D. G., Nelson, M. R., Barton, S. E., Gazzard, B. G. (1992) Malignant otitis externa in a patient with AIDS. International Journal of STD and AIDS 3: 214.CrossRefGoogle Scholar
Dropulic, L. K., Leslie, J. M., Eldred, L. J., Zenilman, J., Sears, C. L. (1995) Clinical manifestations of Pseudomonas aeruginosa infection in patients with AIDS. Journal of Infectious Diseasel 171: 930–937.CrossRefGoogle ScholarPubMed
Ellis, M., Gupta, S., Galant, S. (1988) Impaired neutrophil function in patients with AIDS or AIDS related complex: a comprehensive evaluation. Review of infectious Diseases 158: 1268–1276.Google ScholarPubMed
Evans, I. T. G., Richards, S. H. (1973) Malignant (necrotising) otitis externa. Journal of Laryngology and Otology 87: 13–20.CrossRefGoogle ScholarPubMed
Hamilton, J. R., Overall, J. C. Jr (1978) Synergistic infection with murine cytomegalovirus and Pseudomonas aeroginosa in mice. Journal of Infectious Diseases 137: 775–782.CrossRefGoogle Scholar
Hardy, W. D., Feinberg, J., Finkeistein, D. (1992) A controlled trial of trimethoprimsulfamethoxazole or aerosolized pentamidine for secondary prophylaxis of Pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome. New England Journal of Medicine 327: 1842–1847.CrossRefGoogle ScholarPubMed
Hilf, M., Yu, V. L., Sharp, J., Zuravieff, J. J., Korvick, J. A., Muder, R. R. (1989) Antibiotic therapy for Pseudomonas aeruginosa bacteraemia: outcome correlations in a prospective study of 200 patients. American Journal of Medicine 87: 540–546.CrossRefGoogle Scholar
Kielhofner, M., Atmas, R. L., Hamill, R. J., Musher, D. M. (1992) Life-threatening Pseudomonas aeruginosa infections in patients with human immunodeficiency virus infection. Clinical infectious Diseases 14: 403–411.CrossRefGoogle ScholarPubMed
Lane, H. C., Masur, H., Edgar, L. C., Whalen, G., Rook, A. H., Fauci, A. S. (1983) Abnormalities of B-cell activation and immunoregulation in patients with the acquired immune deficiency syndrome. New England Journal of Medicine 309: 453–458.CrossRefGoogle Scholar
Loranzo, F., Corzo, J. E., Nogales, C., Garcia-Bragado, F. (1992) Life threatening Pseudomonas aeruginosa infections in patients with infection due to human immunodeficiency virus [letter]. Clinical Infectious Diseases 15: 751–752.Google Scholar
Markham, R. B., Pier, G. B., Goellner, J. J., Mizel, S. B. (1985) In-vitro T-cell mediated killing of Pseudomonas aeruginosa. The role of macrophages and T-cell subsets in T-cell killing. Journal of Immunology 134: 4112–4117.CrossRefGoogle ScholarPubMed
Markham, R. B., Pier, G.B., Schreiber, J. R. (1991) The role of cytophilic antibody in T-cell mediated resistance to infection with the extracellular bacterium, Pseudomonas aeruginosa. Journal of immunology 146: 316–320.CrossRefGoogle ScholarPubMed
Meltzer, P. E., Keleman, G. (1959) Pyocutaneous osteomyelitis of the temporal bone, mandible and zygoma. Laryngoscope 169: 1300–1316.CrossRefGoogle Scholar
McElroy, E. A. Jr, Marks, G. L. (1991) Fatal necrotising otitis externa in a patient with AIDS. Review of Infectious Diseases 13: 1246–1247.CrossRefGoogle Scholar
Mendelson, M. H., Gurtman, A., Szabo, S., Neibart, E., Meyers, B., Policar, M., Cheung, T. W., Lillienfeld, D., Hammer, G., Reddy, S., Choi, K., Hirschman, S. Z. (1994) Pseudomonas aeruginosa bacteraemia in patients with AIDS. Clinical Infectious Disease 18: 886–895.CrossRefGoogle ScholarPubMed
Nelson, M. R., Shanson, D. C., Barter, G. J., Hawkins, D. A., Gazzard, B. G. (1991) Pseudomonas septicaemia associated with HIV. AIDS 5: 761–763.CrossRefGoogle ScholarPubMed
Pennington, J. E. (1990) Pseudomonas aeruginosa. Vaccines and immunotherapy. Infectious Disease Clinics of North America 4: 259–270.CrossRefGoogle ScholarPubMed
Pier, G. B., Markham, R. B. (1982) Induction in mice of cell mediated immunity to Pseudomonas aeruginosa by high molecular weight polysaccharide and vinblastine. Journal of Immunology 128: 2121–2125.CrossRefGoogle ScholarPubMed
Powderly, W. G., Schreiber, J. R., Pier, G. B., Markham, R. B. (1988) T-cells recognising polysaccharide-specific B-cells function as contrasuppressors in the generation of T-cell immunity to Pseudomonas aeruginosa. Journal of Immunology 140: 2746–2752.CrossRefGoogle Scholar
Reiss, P., Hadderingh, R., Schot, L. J., Danner, S. A. (1991) Invasive external otitis caused by Aspergillus fumigatus in two patients with AIDS. AIDS 5: 605–606.CrossRefGoogle ScholarPubMed
Rivas Lacarte, M. P., Pumarola Segura, F. (1990) Otitis externa maligna y anticuerpos HIV. A proposito de un caso. Anales Otorrinolaringologicos Ibero-Americanos xvii, 5: 505–512.Google Scholar
Rolsten, K. V. I., Radentz, S., Rodriguez, S. (1990) Bacterial infections in the acquired immune deficiency syndrome. Cancer Detection and Prevention 14: 377–381.Google Scholar
Rubin, J., Yu, V. L. (1988) Malignant external otitis: insights into pathogenesis, clinical manifestations, diagnosis and therapy. American Journal of Medicine 85(3): 391–398.CrossRefGoogle ScholarPubMed
Scott, G. B., Buck, B. E., Leterman, J. G., Bloom, F. L., Parks, W. P. (1984) Acquired immunodeficiency syndrome in children. New England Journal of Medicine 310: 76–81.CrossRefGoogle Scholar
Soliman, A. E. (1978) A rare case of malignant otitis externa in a non-diabetic patient. Journal of Laryngology and Otology 92: 811–812.CrossRefGoogle Scholar
Schrager, L. K. (1988) Bacterial infections in AIDS patients. AIDS (suppl.1) 2: S 183–189.CrossRefGoogle ScholarPubMed
Watson, R. C. (1977) The neuropathology of malignant otitis externa. Bulletin of the Los Angeles Neurological Society 42: 51–56.Google Scholar
Weinroth, S. E., Schessel, D.. Tuazon, C. U. (1994) Malignant otitis externa in AIDS patients: case report and review of the literature. Ear, Nose and Throat Journal 73(10): 772–774, 777–778.CrossRefGoogle ScholarPubMed
Witt, D. J., Craven, D. E., McCabe, W. R. (1987) Bacterial infections in adult patients with the acquired immune deficiency syndrome (AIDS) and AIDS-related complex. American Journal of Medicine 82: 900–906.CrossRefGoogle ScholarPubMed
Youngs, R., Bagley, J. (1986) Sphenoidal sinusitis secondary to malignant otitis externa. Journal of Laryngology and Otology 100: 341–344.CrossRefGoogle Scholar