Necrotizing external otitis in a patient caused by Klebsiella pneumoniae
Journal
European Archives of Oto-Rhino-Laryngology
Journal Volume
263
Journal Issue
4
Pages
344
Date Issued
2006-04-01
Author(s)
Abstract
Necrotizing external otitis is a potentially life-threatening infection involving the temporal and adjacent bones. The most frequent pathogen is attributed to Pseudomonas aeruginosa, but is rarely caused by Klebsiella pneumoniae. Recently, we encountered a 47-year-old diabetic man with a swollen obliterated external ear canal with granulation tissue on the right ear. Image study demonstrated skull base osteomyelitis, epidural abscess and cerebral venous sinus thrombi. It was later proved to be necrotizing external otitis caused by Klebsiella pneumoniae. He then underwent craniotomy for drainage of the epidural abscess, followed by intravenous ciprofloxacin and metronidazole for 2 consecutive weeks until both pus and blood cultures depicted no growth of pathogens. Based on this case, synergistic antibiotic therapy using a third-generation cephalosporin or quinolone (ciprofloxacin), accompanied by metronidazole, and even a short-term aminoglycoside is recommended for the treatment of severe Klebsiella-induced necrotizing external otitis. Surgical intervention should be limited without shedding of the pathogens. © Springer-Verlag 2005.
Subjects
Cerebral venous sinus thrombosis | Klebsiella pneumoniae | Necrotizing external otitis
Publisher
SPRINGER
Type
journal article