Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa
Background: Infections of the external ear canal (EAC) exist as a spectrum of disease from severe otitis externa (SOE) to necrotising otitis externa (NOE), but distinguishing between these is challenging. The UK consensus case definition (UKCCD) was established in 2022, but had not yet been assessed...
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| Format: | Article |
| Language: | English |
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Elsevier
2024-11-01
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| Series: | Clinical Infection in Practice |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2590170224000475 |
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| author | Junko Takata Victoria J. Sinclair Holly Hendron Robert Wilson Laura Wilkins Charlotte Miles Jessica Larwood Alanna Wall Oliver Bannister Monique I. Andersson Susanne H. Hodgson |
| author_facet | Junko Takata Victoria J. Sinclair Holly Hendron Robert Wilson Laura Wilkins Charlotte Miles Jessica Larwood Alanna Wall Oliver Bannister Monique I. Andersson Susanne H. Hodgson |
| author_sort | Junko Takata |
| collection | DOAJ |
| description | Background: Infections of the external ear canal (EAC) exist as a spectrum of disease from severe otitis externa (SOE) to necrotising otitis externa (NOE), but distinguishing between these is challenging. The UK consensus case definition (UKCCD) was established in 2022, but had not yet been assessed in clinical practice. Methods: All consecutive adult patients undergoing CT to investigate a diagnosis of possible NOE between November 2018 and October 2019 were prospectively included in the cohort. Clinical diagnosis at baseline and the end of 12 months follow-up were compared to the diagnosis defined by UKCCD. Results: 55 patients were included in the analysis. 27 % (15/55) had an initial clinical diagnosis of NOE, of which 47 % (7/15) did not have changes on CT consistent with NOE. Only 9 % (5/55) patients had an MRI scan performed within 7 days of the baseline CT. At the end of 12 months, 9 % (5/55) patients had a change in diagnosis to or from NOE. All cases diagnosed as NOE by UKCCD had a clinical diagnosis of ‘NOE’ at baseline, while no cases clinically diagnosed as NOE were mislabelled by UKCCD as ‘not NOE’. All cases that had a change of diagnosis in the 12-month period or had an initial CT with no changes consistent with NOE, were captured by the UKCCD category of ‘possible NOE’. Median duration of antibiotics of clinically defined NOE cases were 14 days of intravenous (IQR: 7.3–23.8), 28 days of oral (IQR: 21.0–40.3), and 49.5 days combined (IQR: 29.8–67.3). Conclusion: UKCCD has excellent clinical concordance with clinical diagnosis. Further work is warranted to assess its utility for risk stratification of patients presenting with severe infections of the EAC in a larger cohort. |
| format | Article |
| id | doaj-art-d9dda96dccbb4a3291574433db38685e |
| institution | Kabale University |
| issn | 2590-1702 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Clinical Infection in Practice |
| spelling | doaj-art-d9dda96dccbb4a3291574433db38685e2024-12-12T05:22:40ZengElsevierClinical Infection in Practice2590-17022024-11-0124100387Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externaJunko Takata0Victoria J. Sinclair1Holly Hendron2Robert Wilson3Laura Wilkins4Charlotte Miles5Jessica Larwood6Alanna Wall7Oliver Bannister8Monique I. Andersson9Susanne H. Hodgson10Department of Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; Corresponding author at: Department of Infection, John Radcliffe Hospital, Oxford University Hospital NHS Foundation Trust, Headley Way, Oxford OX3 9DU, UK.Department of Ear, Nose and Throat Surgery, Oxford University Hospitals NHS Foundation Trust, Oxford, UKUniversity of Oxford Medical School, Oxford, UKUniversity of Oxford Medical School, Oxford, UKUniversity of Oxford Medical School, Oxford, UKUniversity of Oxford Medical School, Oxford, UKUniversity of Oxford Medical School, Oxford, UKUniversity of Oxford Medical School, Oxford, UKDepartment of Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UKDepartment of Infection, Oxford University Hospitals NHS Foundation Trust, Oxford, UK; The Jenner Institute, University of Oxford, Oxford, UKBackground: Infections of the external ear canal (EAC) exist as a spectrum of disease from severe otitis externa (SOE) to necrotising otitis externa (NOE), but distinguishing between these is challenging. The UK consensus case definition (UKCCD) was established in 2022, but had not yet been assessed in clinical practice. Methods: All consecutive adult patients undergoing CT to investigate a diagnosis of possible NOE between November 2018 and October 2019 were prospectively included in the cohort. Clinical diagnosis at baseline and the end of 12 months follow-up were compared to the diagnosis defined by UKCCD. Results: 55 patients were included in the analysis. 27 % (15/55) had an initial clinical diagnosis of NOE, of which 47 % (7/15) did not have changes on CT consistent with NOE. Only 9 % (5/55) patients had an MRI scan performed within 7 days of the baseline CT. At the end of 12 months, 9 % (5/55) patients had a change in diagnosis to or from NOE. All cases diagnosed as NOE by UKCCD had a clinical diagnosis of ‘NOE’ at baseline, while no cases clinically diagnosed as NOE were mislabelled by UKCCD as ‘not NOE’. All cases that had a change of diagnosis in the 12-month period or had an initial CT with no changes consistent with NOE, were captured by the UKCCD category of ‘possible NOE’. Median duration of antibiotics of clinically defined NOE cases were 14 days of intravenous (IQR: 7.3–23.8), 28 days of oral (IQR: 21.0–40.3), and 49.5 days combined (IQR: 29.8–67.3). Conclusion: UKCCD has excellent clinical concordance with clinical diagnosis. Further work is warranted to assess its utility for risk stratification of patients presenting with severe infections of the EAC in a larger cohort.http://www.sciencedirect.com/science/article/pii/S2590170224000475 |
| spellingShingle | Junko Takata Victoria J. Sinclair Holly Hendron Robert Wilson Laura Wilkins Charlotte Miles Jessica Larwood Alanna Wall Oliver Bannister Monique I. Andersson Susanne H. Hodgson Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa Clinical Infection in Practice |
| title | Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa |
| title_full | Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa |
| title_fullStr | Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa |
| title_full_unstemmed | Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa |
| title_short | Preliminary evidence supporting use of UK consensus definitions for necrotising otitis externa |
| title_sort | preliminary evidence supporting use of uk consensus definitions for necrotising otitis externa |
| url | http://www.sciencedirect.com/science/article/pii/S2590170224000475 |
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