Necrotizing Otitis Externa



Necrotizing Otitis Externa


Bruce M. Wenig, MD





Key Facts


Etiology/Pathogenesis



  • External otitis related to Pseudomonas aeruginosa infection


Clinical Issues



  • Diabetic, chronically debilitated, or immunologically deficient patients


  • Primarily affects older patients


  • Mortality rates may exceed 75% if diagnosis and treatment are delayed


Microscopic Pathology



  • Histology dominated by presence of necrotic material and exuberant granulation tissue



    • Diffuse heavy acute and chronic inflammation present in subcutis extending to bone


  • Necrotizing vasculitis commonly present


  • Thick, acellular collagen seen replacing most of subcutis


  • Necrotic bone and cartilage







Epithelial ulceration is seen with a dense inflammatory cell infiltrate image extending to bone image and thick, acellular collagenous bands replacing the subcutis tissues image.






Necrosis image and a dense acute and chronic inflammatory cell infiltrate extending to bone image are identified. The histologic findings coupled to the clinical presentation are diagnostic for NEO.


TERMINOLOGY


Abbreviations



  • Necrotizing external otitis (NEO)


  • External auditory canal (EAC)


Synonyms



  • “Malignant” external otitis


  • Necrotizing granulomatous otitis

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Jul 7, 2016 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Necrotizing Otitis Externa

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