Malignant otitis externa with hematogenous spread of carbapenem resistant Pseudomonas aeruginosa

Patrón-Ordóñez G.; Alania J.C.; Anticona-Sayán M.I.; Resurrección-Delgado C.P.; Cucho-Espinoza C. · Anales de la Facultad de Medicina (2023) · DOI: 10.15381/anales.v84i2.24720

Resumen

Pseudomonas aeruginosa is a non-fermenting Gram-negative bacterium that produces several types of severe infections in immunocompetent and immunosuppressed patients. One of these infections is malignant otitis externa, which occurs mainly in people with diabetes mellitus and can have a torpid evolution coursing with osteomyelitis of skull base and cranial nerve palsies. Treatment is individualized and mainly conservative with culture-guided antibiotic therapy, with isolated pseudomonas being sensitive to anti-pseudomonal antibiotics in the majority of reported cases. We report a case of unusual presentation of malignant otitis externa caused by Pseudomonas aeruginosa resistant to carbapenems with suggestive evidence of bilateral involvement and in which the same germ was isolated in urine and blood cultures, which would indicate hematogenous dissemination of the microorganism.

Instituciones: Universidad Ricardo Palma; Universidad Nacional del Santa