ascorbic-acid and Otitis-Externa

Malignant external otitis is a progressive necrotizing otitis. It's a rare severe and evolutive clinical entities, old diabetics are the most victim. Pseudomonas aeruginosa is the bacteria responsible in the most cases. Prognostic vital can be affected, treatment must be energic, rapid and well adapted. The authors report two old diabetic women presenting a malignant external otitis and discuss etiopathogenic, physiopathologic, diagnosis and treatment of this illness.

Topics: Anti-Bacterial Agents; Ascorbic Acid; Diabetes Complications; Diagnosis, Differential; Female; Humans; Hyperbaric Oxygenation; Middle Aged; Otitis Externa; Prognosis; Risk Factors

The knowledge of cell-molecular characteristics of middle ear inflammation in children allowed the authors to suggest a beneficial effect of antioxidants in this disease. The trial of ascorbic acid, retinol and alpha-tocopherol as components of combined treatment has confirmed this hypophysis in view of high response achieved in children with middle ear purulent inflammation.

Topics: Adolescent; Antioxidants; Ascorbic Acid; Cell Membrane; Child; Child, Preschool; Drug Combinations; Drug Therapy, Combination; Humans; Infant; Lipid Peroxidation; Otitis Externa; Otitis Media, Suppurative; Spectrophotometry; Treatment Outcome; Vitamin A; Vitamin E

Malignant external otitis (MEO) is a rare disease due to a Pseudomonas infection of the external ear occurring in an elderly patient with uncontrolled diabetes mellitus. Its high mortality raises the question of an alteration of the defense mechanisms of the body. A 58-year-old man was affected with MEO, and after several months of unsuccessful treatment, a study of the function of his polymorphonuclear neutrophil leukocytes (PMNs) revealed a defect of the migration capability. Ascorbic acid (vitamin C) was proved in vitro to be able to improve the results of the migration test. The patient was treated for one month with ascorbic acid and, parallel to the normalization of the chemotaxis test results, the ear lesions healed. The mechanism of such an alteration of the PMN function, implying several factors (the active infection, old age, and diabetes mellitus), is still unclear. Nevertheless, it is certainly important to test the PMN function in patients with MEO and treat them with immunomodulators.

Topics: Ascorbic Acid; Chemotaxis, Leukocyte; Humans; Male; Middle Aged; Neutrophils; Otitis Externa; Pseudomonas Infections