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老年糖尿病合併惡性外耳炎:病例報告及文獻回顧

Malignant Otitis Externa in an Elderly Diabetic Patient: A Case Report and Literature Review

摘要


我們報告一位惡性外耳炎(Malignant otitis externa)合併多處腦神經侵犯的病患。一位84歲糖尿病(Diabetes mellitus)患者出現嚴重的右耳疼痛與右耳耳漏已有兩週,經局部耳藥治療後無效,且接著出現右側顏面神經麻痺的症狀。雖然病患接受靜脈抗生素治療14週與高壓氧治療三次,仍舊繼續併發第九與第十對腦神經侵犯,並且死亡。當糖尿病病患出現耳痛、耳漏的症狀而對局部的治療無反應時,應考慮惡性外耳炎,早期診斷與適當的治療可以降低死亡率。

關鍵字

糖尿病 惡性外耳炎

並列摘要


A case of malignant otitis externa with multiple cranial nerve deficits is presented. A 84-year-old diabetic male patient presented with severe right otalgia and otorrhea for two weeks and did not respond to ordinary treatment. The patient also noticed a progressive facial weakness on the same side. Despite 14-week intravenous antibiotic therapy and hyperbaric oxygen therapy, cranial nerve IX and X deficits followed and the patient died. Malignant otitis externa should be suspected in diabetic patients presenting with aural discharge not respond to ordinary treatment. Successful treatment depends on early diagnosis and proper therapy.

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