PDF(Pubmed)
Abstract：
Malignant otitis externa (skull base osteomyelitis) can be fatal and long-term antibiotic therapy is recommended. Despite being potentially fatal, this infection causes minor changes in inflammatory biomarkers (white blood cell count and C-reactive protein levels) upon blood testing. Computed tomography and magnetic resonance imaging changes persist over a long period. Therefore, it is difficult to determine the optimal time for the discontinuation of antibiotics. We present a 77-year-old male whose medical history included type 2 diabetes mellitus who suffered from chronic otitis media with Pseudomonas aeruginosa infection. His condition did not improve with proper treatment, and imaging revealed malignant otitis media. Intravenous cefepime treatment was administered. Antibiotic treatment was de-escalated to oral levofloxacin treatment after Gallium-67 scintigraphy showed less accumulation after 6 weeks of Cefepime administration; accumulation almost disappeared after 1 year. In this report, we describe the usefulness of gallium scintigraphy in the evaluation of malignant otitis externa.
摘要：
恶性外耳炎（颅底骨髓炎）可能是致命的，建议长期抗生素治疗。尽管可能致命，这种感染在血液检测时引起炎症生物标志物(白细胞计数和C反应蛋白水平)的微小变化.计算机断层扫描和磁共振成像的变化会持续很长时间。因此,很难确定抗生素停药的最佳时间。我们介绍了一名77岁的男性，其病史包括2型糖尿病，患有铜绿假单胞菌感染的慢性中耳炎。经过适当的治疗，他的病情没有改善，影像学显示恶性中耳炎。给予静脉头孢吡肟治疗。头孢吡肟给药6周后，67镓闪烁显像显示积累较少，抗生素治疗逐步升级为口服左氧氟沙星治疗；1年后积累几乎消失。在这份报告中,我们描述了镓闪烁显像在恶性外耳炎评估中的有用性。
