Pseudomonas aeruginosa remains the dominant pathogen in osteomyelitis of the temporal bone.

Osteomyelitis of the temporal bone (OTB) is a rare inflammatory disease that can spread from the ear canal to adjacent soft tissue and bone structures. This expansion is challenging to treat and thus can become life-threatening. The detection of the causative pathogen is crucial for successful therapy. Current studies have revealed a diverse spectrum of pathogenic microorganisms in OTB. The aim of our study was to compare the microbiological background of our OTB-patients with data in recent literature.In this retrospective, single-center study patients diagnosed with OTB over a 10-year period were included (n=39). We analyzed the microbiological spectrum, clinical symptoms, radiological findings and course of the disease.Most common symptoms were otalgia (n=29, 74.4%) and otorrhea (n=24, 61.5%). Microbiological assessment showed most frequently P. aeruginosa (n=21, 53.8%) and the detection of this pathogen was associated with increased CRP levels (p<0.05). Computed tomography showed a washed-out bone texture of the petrous bone in 38 patients (97.4%). During the follow-up period 10 patients (25.6%) reported an improvement of symptoms, whereas 23 patients (59.0%) described their persistence. Four patients (10.3%) died.In contrast to recently published data, in our patient cohort P. aeruginosa remains the most common and challenging causative pathogen of OTB. Therefore, when selecting an empirical therapy attention should always be given to its efficacy against this pathogen.