Malignant Otitis Externa in an 87-year-old Long Term Care Resident

Malignant otitis externa is a life-threatening infection of the external ear canal and skull base that initially begins as otitis externa. Most affected patients have diabetes or are immunocompromised and are older than 60 years of age. Diagnosis requires the presence of pain out of proportion to the physical exam, edema, exudate or granulations in the external auditory canal, micro-abscess, positive bone scan, and failure of local treatment for at least one week. Workup varies, however, ESR and CRP are usually elevated.