Clinico-microbiological assessment of necrotizing otitis externa in subjects with diabetes mellitus in India.

Necrotizing otitis externa (NOE) represents a severe progression of otitis externa, particularly threatening in diabetic patients, with limited clinico-microbiological data for Indians. Therefore, it is of interest to evaluate the clinico-microbiological profile in 60 diabetic adults diagnosed with NOE at a tertiary center. Among participants (mean age 60.51±9.6 years; 60% male), universal findings included external auditory canal edema, otorrhea and severe nocturnal otalgia; pus cultures grew Pseudomonas spp. in 43.3% (n=26), with no growth in 13.3% (n=8), mild conductive hearing loss in 16.7% (n=10) and facial nerve palsy (with/without glossopharyngeal involvement) in 6.7% (n=4). Pseudomonas dominance and characteristic symptoms align with global patterns, but high complication rates underscore local management gaps. Thus, we report the Indian cohort profile of NOE in diabetes, informing targeted antibiotic strategies and early cranial nerve monitoring.