Unusual Case of Necrotizing External Otitis

A 66-year-old caucasian, diabetic male came to our emergency room with an medical treatment refractory acute external otitis. He was then admitted for a week, with resolution of the earache and the discharge; 3 months after, he recurred again to our emergency room with headache, left earache, left hypoacusis and complaining of progressive imbalance, without otorrhea. He undergone ear MRI which revealed osteomyelitis located on left petrous apex. He was again admitted with a rigorous glycemic control, antibiotherapy and hyperbaric oxygenotherapy; After 16 weeks of parenteral antibiotic treatment, the patient was discharged, and treatment was continued with oral ciprofloxacin for 4 months, leading to a radiological complete response.