Journal Mobile

ACM Thompson, I Zammit-Maempel, F Stafford, M Narayanan, NS Kanagasundaram
Journal Issue: 
Volume 40: Issue 1: 2010




We  present  an  unusual  case  of  necrotising  otitis  externa  (NOE) causing  a  lower  motor  neurone  facial  nerve  palsy  in  a  patient  with  diabetes mellitus  and  receiving  maintenance  haemodialysis  for  end-stage  renal  disease (ESRD). Pseudomonas aeruginosa is the most common pathogen isolated in NOE, although our case involved the non-typical pathogens Aspergillus flavus and Proteus mirabilis.  We  discuss  the  need  for  diagnostic  rigour  and  the  importance  of considering  atypical  infective  pathology  in  patients  with  ESRD  or  diabetes mellitus.  We review NOE with reference to causative agents, imaging strategies, prognostic indicators and treatment.