Pseudomonas infection of the external ear is a progressive necrotizing infection of the soft tissues with a propensity for extensive involvement of the temporal bone. It occurs principally in elderly diabetics and is accompanied by substantial morbidity and high mortality. Paramount in its management are rigid control of the diabetes, meticulous debridement of the external auditory canal, topical and systemic antibiotic therapy, use of local antiinflammatory agents, and extensive surgical debridement when the infection invades beyond the confines of the skin. It is suggested that a Pseudomonas infection of the middle ear and mastoid in diabetic patients will have the same morbid potential, and the term progressive necrotizing otitis is offered to describe these entities.
Cohn AM. Progressive Necrotizing Otitis: Malignant External Otitis. Arch Otolaryngol. 1974;99(2):136–139. doi:10.1001/archotol.1974.00780030142015
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