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Malignant Otitis Externa (MOE) / Necrotizing External Otitis

Malignant otitis externa (MOE), also known as necrotizing external otitis, is a rare but serious infection that affects the outer ear canal and adjacent structures. It occurs most commonly in elderly individuals with underlying health conditions such as diabetes, HIV, or other conditions that weaken the immune system.

MOE is caused by a bacterial infection, typically Pseudomonas aeruginosa, that spreads from the ear canal to the surrounding tissues, including the bone of the skull base. This can lead to significant tissue damage and potentially life-threatening complications.

Symptoms of MOE include severe pain and inflammation of the ear canal, discharge from the ear, hearing loss, and facial weakness or paralysis. If the infection spreads to the skull base, it can cause headaches, fever, and changes in mental status.

Diagnosis of MOE typically involves a thorough physical exam and imaging studies such as a CT scan or MRI. Treatment for MOE often involves aggressive antibiotic therapy, typically given intravenously. In some cases, surgery may be necessary to remove damaged tissue or to drain fluid or pus that has accumulated in the affected area.

Complications of MOE can be serious and potentially life-threatening, including the spread of infection to other parts of the body, meningitis, and brain abscess. Early diagnosis and treatment are critical in preventing these complications.

Prevention of MOE involves good ear hygiene and prompt treatment of any ear infections or injuries. It is important to avoid inserting foreign objects into the ear canal and to seek medical attention if any symptoms of ear infection or inflammation are present.

In summary, malignant otitis externa is a rare but serious infection that affects the outer ear canal and adjacent structures. It is typically caused by a bacterial infection and occurs most commonly in elderly individuals with underlying health conditions. Symptoms include severe pain and inflammation of the ear canal, hearing loss, and potentially life-threatening complications. Treatment involves aggressive antibiotic therapy and in some cases, surgery. Prevention measures include good ear hygiene and prompt treatment of any ear infections or injuries.

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