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Characteristics, management and outcome of a large necrotising otitis externa case series: need for standardised case definition

Hodgson, SH; Sinclair, VJ; Arwyn-Jones, J; Oh, K; Nucken, K; Perenyei, M; Sivapathasingam, V; ... Andersson, MI; + view all (2022) Characteristics, management and outcome of a large necrotising otitis externa case series: need for standardised case definition. Journal of Laryngology and Otology , 136 (7) pp. 604-610. 10.1017/S002221512100462X. Green open access

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Abstract

Background: Necrotising otitis externa (NOE) is a severe ear infection for which there are no established diagnostic or treatment guidelines. Objective: Describe clinical characteristics, management and outcomes for patients managed as NOE at a UK tertiary referral centre. Methods: Retrospective case series. Results: 58 (63%) patients were classified as definite NOE cases, 31 (34%) as probable and 3 (3%) as possible cases. Median duration of intravenous and oral antimicrobial therapy was 6.0 weeks (0.49-44.9). 6% of patients relapsed a median of 16.4 weeks (IQR 23-121) after stopping antimicrobials. 28% of cases had complex disease. These patients were older (p=0.042), had a longer duration of symptoms prior to imaging (p= 0.0001) and higher CRP at diagnosis (p=0.005). Despite longer courses of intravenous antimicrobials (23 days v 14 days; p=0.032), complex cases were more likely to relapse (p=0.016). Conclusion: A standardised case-definition of NOE is needed to optimise diagnosis, management and research.

Type: Article
Title: Characteristics, management and outcome of a large necrotising otitis externa case series: need for standardised case definition
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1017/S002221512100462X
Publisher version: https://doi.org/10.1017/S002221512100462X
Language: English
Additional information: Copyright © The Author(s), 2022. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED. This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
Keywords: Necrotising, Malignant, Otitis, Externa, Pseudomonas, Antimicrobial
UCL classification: UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Div of Infection and Immunity
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10143819
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