Acute otitis externa
Redness of ear pinna, ear discharge, pain and right trismus in a known diabetic
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Swollen inflamed right external ear cartilage and pinna with soft tissue within the external auditory canal. Air fluid levels seen in mastoid air cells. Fatty replaced parotid gland shows intrasubstance edema with multiple subcentimetric intraparotid lymph nodes. Multiple enlarged right upper cervical lymph nodes seen.
Diabetic patients are less aware of infections secondary to the neuropathy involved and tend to present when infection has eaten up quite a bit. This was a case of a fiery looking external ear with inflammation that progressed quickly in the last two weeks resulting in restriction of right jaw movement. Fortunately the MRI finds no extension to involve the temporomandibular joint. This study shows active inflammation of the external ear, parotid gland and mastoid air cells with reactive cervical lymphadenopathy.
Importantly there is no intra cranial extension, dural sinus thrombosis or any form of meningitis / epidural abscess.