Malignant Otitis Externa Symptoms and Diagnosis

Primary Symptoms

Malignant otitis externa presents with severe, unrelenting deep otalgia (ear pain) that is often disproportionate to examination findings, persistent purulent otorrhea (ear discharge), and granulation tissue typically seen on the floor of the ear canal and at the bony-cartilaginous junction, according to the American Academy of Otolaryngology-Head and Neck Surgery 1
Granulation tissue in the external auditory canal, particularly at the floor and bony-cartilaginous junction, is a characteristic finding in malignant otitis externa, as noted by the American Academy of Otolaryngology-Head and Neck Surgery 1

Headache, vertigo, and meningismus (neck stiffness) in cases with intracranial spread are potential complications of malignant otitis externa, as reported by the American College of Radiology 2
Regional lymphadenitis is a possible complication of malignant otitis externa, according to the American Academy of Otolaryngology-Head and Neck Surgery 3

Malignant otitis externa shows more severe, persistent symptoms compared to acute otitis externa, and the presence of granulation tissue is characteristic of malignant otitis externa but not typical in acute otitis externa, as noted by the American Academy of Otolaryngology-Head and Neck Surgery 1
Malignant otitis externa involves bone invasion and potential intracranial spread, unlike acute otitis externa, as reported by the American College of Radiology 2

Treatment of malignant otitis externa requires long-term antimicrobial therapy with antipseudomonal coverage, as recommended by the American College of Radiology 2