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Necrotizing (Malignant) Otitis Externa

last modified on: Wed, 08/30/2017 - 11:05

 

Necrotizing / Malignant Otitis Externa

Pathophysiology

Diagnosis

  • Imaging
    • For diagnosis, obtain Technecium-99 bone scan (in UIHC EPIC, order as "NUC BONE SCAN SPECT". Radiopharmacologist will order Tc99 injection prior to scan
    • To evaluate for resolution of disease, obtain Indium-111 tagged WBC scan (in UIHC EPIC, order as "NUC ABSCESS LOCAL LTD, BM, IN-111 WBC/BONE, OSTEO")

Treatment

  • Antibiotics, consider double coverage for Pseudomonas
    • Zosyn-- adjust dosage if renal disease
    • Ciprofloxacin
  • PICC
  • Consider infectious disease consult