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