PDF(Pubmed)
Abstract：
Malignant otitis externa (MOE) with skull base osteomyelitis (SBO) is an aggressive infection that predominantly affects elderly, diabetic, or immunocompromised patients, and is associated with high disease-specific mortality. Pseudomonas aeruginosa is the most isolated microorganism. External otitis associated with granulation tissue and pain is the most common presenting feature; a biopsy is obtained to rule out malignancy. A proper consensus is lacking regarding the best imaging modality for early initial diagnosis and follow-up. 99mTechnetium (99mTc)-labeled ubiquicidin (UBI) 29-41 is a bacterial attaching peptide that does not bind to activated leukocytes. We report a case of SBO initially misdiagnosed as a chronic otitis media, but later proved to be a case of MOE. 99mTc methylene diphosphonate bone scan and 99mTc-UBI 29-41 scan with single-photon emission computed tomography/computed tomography scans were performed to corroborate the clinical diagnosis. SBO remains a great challenge due to its increasing prevalence and high morbidity are difficult to diagnose and are often confused with cholesteatoma and neoplastic process. The UBI scan could be an auxiliary noninvasive diagnostic alternative in early diagnosis.
摘要：
恶性外耳炎（MOE）伴颅底骨髓炎（SBO）是一种侵袭性感染，主要影响老年人，糖尿病,或者免疫功能低下的患者，并与高疾病特异性死亡率相关。铜绿假单胞菌是最分离的微生物。与肉芽组织和疼痛相关的外耳炎是最常见的表现特征；获得活检以排除恶性肿瘤。关于早期初步诊断和随访的最佳成像方式缺乏适当的共识。99mTech（99mTc）标记的泛奎素（UBI）29-41是一种细菌附着肽，不与活化的白细胞结合。我们报告一例SBO最初误诊为慢性中耳炎，但后来证明是MOE的案例。进行99mTc亚甲基二膦酸盐骨扫描和99mTc-UBI29-41扫描以及单光子发射计算机断层扫描/计算机断层扫描以证实临床诊断。SBO仍然是一个巨大的挑战，因为它的患病率不断增加，高发病率难以诊断，并且经常与胆脂瘤和肿瘤形成过程相混淆。UBI扫描可能是早期诊断的辅助非侵入性诊断替代方法。
