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Necrotizing (Malignant) Otitis Externa

last modified on: Mon, 04/01/2024 - 09:15

Note: last updated before 2015



  • 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")


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


(references added 2024 for future updates)

Costa MB, Onishi ET. Necrotizing Otitis Externa: A Proposal for Diagnostic and Therapeutic Approach. Int Arch Otorhinolaryngol. 2023 Sep 26;27(4):e706-e712. doi: 10.1055/s-0042-1758719. PMID: 37876706; PMCID: PMC10593509.