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

Lookup NU author(s): Dr Ivan Zammit-Maempel, Dr Suren Kanagasundaram


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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. © 2010 Royal College of Physicians of Edinburgh.

Publication metadata

Author(s): Thompson A, Zammit-Maempel I, Stafford F, Narayanan M, Kanagasundaram N

Publication type: Article

Publication status: Published

Journal: Journal of the Royal College of Physicians of Edinburgh

Year: 2010

Volume: 40

Issue: 1

Pages: 26-28

Print publication date: 01/01/2010

ISSN (print): 1478-2715

ISSN (electronic): 2042-8189

Publisher: Royal College of Physicians of Edinburgh


DOI: 10.4997/JRCPE.2010.106


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