Eagle_303
Forum Guru
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Posts: 655
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2. A 70-year-old patient with long-standing type 2 diabetes mellitus presents
with complaints of pain in the left ear with purulent drainage. On
physical exam, the patient is afebrile. The pinna of the left ear is tender, and
the external auditory canal is swollen and edematous. The peripheral white
blood cell count is normal. The organism most likely to grow from the purulent
drainage is
a. Pseudomonas aeruginosa
b. Staphylococcus aureus
c. Candida albicans
d. Haemophilus influenzae
e. Moraxella catarrhalis
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| docdoc9
Forum Guru
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Posts: 521
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a.Pseudomonas aeruginosa (otitis externa)
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| drms
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Posts: 947
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A
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| Eagle_303
Forum Guru
Topics: 77
Posts: 655
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2. The answer is a. (Braunwald, 15/e, p 190.) Ear pain and drainage in an
elderly diabetic patient must raise concern about malignant external otitis.
The swelling and inflammation of the external auditory meatus strongly
suggest this diagnosis. This infection usually occurs in older diabetics and
is almost always caused by P. aeruginosa. H. influenzae and M. catarrhalis
frequently cause otitis media, but not external otitis.
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