Malignant otitis externa

Malignant otitis externa - is one of the rarest and most serious complications of otitis externa. The first symptoms of the disease have been described in 1838, but even then, many decades later, researchers could not pinpoint the cause of their appearance. Only in 1968 malignant otitis externa has been defined as a distinct disease and its clinical signs were described in detail. The disease has been called malignant because of its aggressive course, a very poor prognosis and high mortality among patients. When were effective antibiotics for the treatment of otitis externa, forecasts have become much more favorable. Frightening name of the disease, although it is not related to cancer, left, and perhaps for good reason - this form of otitis media still can lead to very serious consequences for health.

Malignant external otitis Otitis - than could face an ear infection   referred to as an infection of the external auditory canal and the temporal bone.

This disorder is uncommon, and it is most common among adults and the elderly. For example, in the UK in 2012 and 2013 malignant external otitis was diagnosed, in total, 810 people, and more than 700 of these patients were older than 60 years. In general, malignant otitis media is much more common in countries with warm and humid climates than in cold and dry areas.

Approximately 90% of patients with this disorder suffer from diabetes. Currently, diabetes (both first and second type) is considered the most significant risk factor for the development of malignant otitis externa. The predisposition to the development of this disorder is not necessarily related to the severity of forms of diabetes in an individual patient.

The risk of malignant otitis increases and other violations that weaken the immune system (eg AIDS), and patients taking immunosuppressants. For AIDS patients, the prognosis of malignant otitis usually less favorable than for diabetics.

Symptoms of the disease are usually severe pain in the ears, that does not go and does not weaken over time; selection with a strong smell, hearing impairment. In addition, approximately 30% of patients with this disorder there is facial paralysis The facial nerve when a person loses symmetry . To diagnose malignant otitis externa and eliminate cancer, a biopsy is sometimes required.

For the treatment of oral appointed (sometimes - intravenous) antibiotics such Antibiotics - whether they will help you in the foreseeable future? As ciprofloxacin Ciprofloxacin - action time-tested , Ceftazidime and / or drugs from the group of penicillins. The average duration of treatment for malignant otitis was 8.8 weeks in the range of 4 to 17 weeks. How long does a patient have to take antibiotics depends mainly on the severity of the disease and the general state of health. Usually the symptoms of malignant otitis externa disappear long before the treatment ends, but it is too early to stop taking antibiotics can not - otherwise the probability of relapse and other complications.

According to various estimates, from 9-27% of patients with malignant external otitis relapse - it can happen within a year after treatment is completed.

The mortality rate among people with this disorder is now less than 10%, whereas prior to the advent of modern antibiotics kills about half of cases. Most likely death in people with very weak immune system.

Symptoms - clinical features

The development of purulent inflammation is a sign of a more severe sinusitis. Purulent sinusitis symptoms must be differentiated in a timely manner, has been appointed to a course of anti-inflammatory therapy. A prerequisite for correct installation of the diagnosis is the use of additional laboratory studies, primarily X-ray examination.

The symptoms of purulent inflammation

With the development of purulent inflammation should pay attention to the general condition of the patient. The inflammatory process in the oral sinus affects the well-being, there are complaints:

• marked weakness
• malaise, constant fatigue
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• decreased appetite
• decreased performance

It is also noted the reaction temperature, body temperature can rise above 37, 5-38 C. These signs listed relate to general signs of inflammation. Local symptoms of purulent sinusitis are a direct confirmation of the localization of the pathological process. Permanent symptom is headache Headache: Causes and Complications Which may extend to the front of the skull. Pain symptom is permanent, it can be enhanced by changing the position of the head, sneezing, coughing. Patients describe the pain is bursting, sometimes is aching in nature. By clicking on the nose, forehead marked local pain, which is intense. When purulent inflammation, patients reported the appearance of tearing and photophobia.

One of the earliest symptoms of purulent sinusitis is nasal congestion. Due to the inflammatory process disrupted the normal air exchange between the maxillary sinus and nasal cavity, so the discharge from the sinus can not evacuate on their own. Stagnation inflammatory secretion in the absence of oxygen leads to the fact that increased bacterial growth occurs. Purulent secretion accumulated in the sinus, is accompanied by a specific odor from the nose, as well as from the oral cavity.

The chronic form of the disease

Purulent inflammation in the sinuses is a type of chronic process. In most cases, inflammation is one-sided, both sinuses are rarely affected. Long term for inflammation leads to pathological changes of the mucosa, to the development of hypertrophic growths and polyps. Polyps can grow rapidly and fill the nasal cavity, with clearly visible in an objective examination. This disrupts the function of smell, normal nasal breathing becomes impossible.

One of the clinical symptoms of purulent sinusitis are purulent nasal discharge. This feature is not constant, since the difficulty of outflow from the chamber abnormal discharge may be missing. If the process of cleansing the cavity is not completely broken, you should pay attention to the appearance of secretions yellow-green color. In some cases, may be present in secretions Discharges in women when there is cause for concern   admixture of blood. The color indicates the presence of bacterial flora, which is the cause of purulent discharge. If signs of a cold, when there are nasal mucus Mucus - what is the norm for a healthy woman It is necessary to monitor changes in their nature. In the absence of the effect of treatment within the first five days, and the appearance of purulent nature we can talk about the development of purulent sinusitis as a complication of colds.