NECROTIZING OTITIS EXTERNA IN PAEDIATRIC PATIENT WITH PRIMARY

IMMUNODEFICIENCY: A RARE CASE REPORT

R. Ayu Anatriera1, Harim Priyono2, Trimartani3, Zakiudin Munasir4, Hindra Irawan Satari5

1Otorhynolaryngology, Head and Neck Surgery Department RSUPN Dr. Cipto Mangunkusumo
2Otology Division Otorhynolaryngology, Head and Neck Surgery Department RSUPN Dr. Cipto
Mangunkusumo
3Plastic Recosntruction Division Otorhynolaryngology, Head and Neck Surgery Department RSUPN

Dr. Cipto Mangunkusumo

4Allergy Immunology Division Pediatrics Department RSUPN Dr. Cipto Mangunkusumo

5Tropical Infection Division Pediatrics Department RSUPN Dr. Cipto Mangunkusumo

Abstract

Necrotizing otitis externa (NOE) is a rare infection of external auditory canal and adjacent
anatomic structures, including bone. NOE commonly affecting immunocompromomised
patient and had mortality rates of nearly 50% if treatment is not sufficient. The sequence of
NOE in children has more insidious symptoms of fever, malaise, leukocytosis, and higher
incidence of facial nerve paralysis in some studies. About 90% necrotizing otitis externa in
children is caused by Pseudomonas, though some cases due to other microorganism. Patients
with primary immunodeficiency (PID) considered by errors in immune response. The incidence
of PID is still undoubtedly underdiagnosed. Most pediatric PID cases of necrotizing otitis
externa resolve within several weeks of intravenous antibiotics administration, although longer
sequences can be required. This paper reported a case of primary immunodeficiency in
paediatric patients along with necrotizing otitis externa as its severe infection and
complications. The aim of this paper explained about proper diagnosis and management of
the disease hence could prevent serious complications and mortality.

Keywords: Necrotizing otitis externa, paediatric, primary immunodeficiency