Abstract：
BACKGROUND: Although rare, Malignant otitis externa is responsible for a high morbidity and could sometimes be fatal. The management of this condition is still challenging.
OBJECTIVE: To analyse the clinical, microbiological and radiological profile of malignant otitis externa, and the management of this condition.
METHODS: A descriptive, cross-sectional study was conducted at ENT Department of Kairouan\'s hospital including 38 patients hospitalised and treated for malignant otitis externa from January 2013 to August 2021.
RESULTS: The mean age of patients was 67.7 ± 12.9 years (35-98). All patients presented with continuous otalgia that resists to usual analgesics. Otorrhea was noticed in 76.3% of cases, facial palsy in 2 cases (5.3%) and dysphonia in one case (2.6%). Pseudomonas Aeruginosa was the main responsible pathogen (42%). Concomitant bacterial and fungal infection was noticed in 6.4% of the cases. First-line intravenous antibiotherapy used was mainly based on an association of Cephalosporins and Fluoroquinolones. Complete remission was noticed in 30 patients (79%). However, 8 cases of recurrences (21%) and 2 cases of deaths (5.2%) were noticed in our series. The mean follow-up was 4.6±6.3 (1-26 months).
CONCLUSIONS: Pseudomonas Aeruginosa remains the main responsible pathogen for malignant otitis externa. Nevertheless, fungal infections are rising because of the overuse of antibiotics. Antibiotherapy should be adapted to culture results and resistance profile of pathogens in hospital. Practionners should be aware of the possibility of concomitant fungal infection, especially in the case of unfavorable evolution.
OBJECTIVE: To analyse the clinical, microbiological and radiological profile of malignant otitis externa, and the management of this condition.
METHODS: A descriptive, cross-sectional study was conducted at ENT Department of Kairouan\'s hospital including 38 patients hospitalised and treated for malignant otitis externa from January 2013 to August 2021.
RESULTS: The mean age of patients was 67.7 ± 12.9 years (35-98). All patients presented with continuous otalgia that resists to usual analgesics. Otorrhea was noticed in 76.3% of cases, facial palsy in 2 cases (5.3%) and dysphonia in one case (2.6%). Pseudomonas Aeruginosa was the main responsible pathogen (42%). Concomitant bacterial and fungal infection was noticed in 6.4% of the cases. First-line intravenous antibiotherapy used was mainly based on an association of Cephalosporins and Fluoroquinolones. Complete remission was noticed in 30 patients (79%). However, 8 cases of recurrences (21%) and 2 cases of deaths (5.2%) were noticed in our series. The mean follow-up was 4.6±6.3 (1-26 months).
CONCLUSIONS: Pseudomonas Aeruginosa remains the main responsible pathogen for malignant otitis externa. Nevertheless, fungal infections are rising because of the overuse of antibiotics. Antibiotherapy should be adapted to culture results and resistance profile of pathogens in hospital. Practionners should be aware of the possibility of concomitant fungal infection, especially in the case of unfavorable evolution.
摘要：
背景：虽然罕见，恶性外耳炎是高发病率的原因，有时可能是致命的。这种情况的管理仍然具有挑战性。
目的：分析临床，恶性外耳炎的微生物学和放射学特征，以及这种情况的管理。
方法：描述性，横断面研究是在Kairouan医院耳鼻喉科进行的,包括2013年1月至2021年8月期间因恶性外耳道炎住院治疗和治疗的38例患者.
结果：患者的平均年龄为67.7±12.9岁（35-98岁）。所有患者均表现为持续的耳痛，对常规镇痛药有抵抗力。76.3%的病例出现耳漏,面神经麻痹2例(5.3%),发声困难1例(2.6%)。铜绿假单胞菌是主要病原体(42%)。6.4%的病例同时伴有细菌和真菌感染。使用的一线静脉抗生素治疗主要基于头孢菌素和氟喹诺酮类药物的关联。30例患者（79％）完全缓解。然而,在我们的系列中发现了8例复发（21％）和2例死亡（5.2％）。随访1～26个月,平均4.6±6.3。
结论：铜绿假单胞菌仍然是恶性外耳炎的主要病原体。然而，由于抗生素的过度使用，真菌感染正在上升。抗生物治疗应适应医院病原体的培养结果和耐药性。从业者应该意识到伴随真菌感染的可能性，尤其是在不利进化的情况下。
目的：分析临床，恶性外耳炎的微生物学和放射学特征，以及这种情况的管理。
方法：描述性，横断面研究是在Kairouan医院耳鼻喉科进行的,包括2013年1月至2021年8月期间因恶性外耳道炎住院治疗和治疗的38例患者.
结果：患者的平均年龄为67.7±12.9岁（35-98岁）。所有患者均表现为持续的耳痛，对常规镇痛药有抵抗力。76.3%的病例出现耳漏,面神经麻痹2例(5.3%),发声困难1例(2.6%)。铜绿假单胞菌是主要病原体(42%)。6.4%的病例同时伴有细菌和真菌感染。使用的一线静脉抗生素治疗主要基于头孢菌素和氟喹诺酮类药物的关联。30例患者（79％）完全缓解。然而,在我们的系列中发现了8例复发（21％）和2例死亡（5.2％）。随访1～26个月,平均4.6±6.3。
结论：铜绿假单胞菌仍然是恶性外耳炎的主要病原体。然而，由于抗生素的过度使用，真菌感染正在上升。抗生物治疗应适应医院病原体的培养结果和耐药性。从业者应该意识到伴随真菌感染的可能性，尤其是在不利进化的情况下。
