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Necrotising otitis externa: an unusual cause of cranial nerve palsy in a diabetic haemodialysis patient.

Authors
  • Thompson, A C
  • Zammit-Maempel, I
  • Stafford, F
  • Narayanan, M
  • Kanagasundaram, N S
Type
Published Article
Journal
The journal of the Royal College of Physicians of Edinburgh
Publication Date
Mar 01, 2010
Volume
40
Issue
1
Pages
26–28
Identifiers
DOI: 10.4997/JRCPE.2010.106
PMID: 21125035
Source
Medline
License
Unknown

Abstract

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.

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