👂 ST3: Necrotising Otitis Externa
Vignette:
A 76-year-old diabetic gentleman has been seen in the rapid access ENT clinic with significant otalgia and otorrhoea by the senior house officer weekly for 5 weeks. You are asked to review as he is not improving. How would you manage this situation?
😮 Opening Gambit:
- I am concerned this patient may have necrotising otitis externa
- This is a hearing and potentially life threatening condition
- With neurological, thrombotic and septic complications
- NOE has a mortality rate of up to 10% and so prompt identification and treatment is paramount
- I would attend to this patient promptly as this patient may require hospital admission
📱 Phone advice:
- Over the phone I would ask for :
- A set of observations including a blood sugar level
- Pure tone audiogram and tympanogram
- Set up the microscope
- Microbiology swab and the biopsy kit
🚑 A-E Assessment (not relevant):
On arrival, if the patient is unstable I would manage them using the advanced life support algorithm, however assuming the patient is in clinic he is stable.