Malignant External Otitis: Now a Medical Problem

A 75-yr-old diabetic woman presented with right ear tenderness and neck pain. Pseudomonas aeruginosa was cultured during surgery from an inflammatory area in the region of the cervical vertebrae. A diagnosis of malignant external otitis was made and parenteral antibiotics were given, which produced a cure. This disease has a high mortality rate, which accounts for the use of the word malignant. Our patient also manifested the jugular foramen syndrome involving multiple cranial nerves. If there is cranial nerve involvement, which is seen in at least one-half of cases, the mortality ranges as high as 80%. We describe here the first case with invasion of the cervical vertebrae.