Malignant External Otitis

Reviewed/Revised Modified Feb 2026
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What is malignant external otitis?

Malignant external otitis is a serious infection of your ear canal. It's not cancer, even though the word "malignant" usually refers to cancer.

Your ear canal is the tube that connects the outside of your ear to your eardrum. This infection is life threatening because it spreads from your ear canal into the surrounding bone of your skull.

  • Bacteria cause the infection (including methicillin-resistant Staphylococcus aureus [MRSA])

  • The risk of malignant external otitis is higher if you have diabetes or a weakened immune system

  • If untreated, it can spread and can paralyze the nerves in your face so that you're unable to move parts of your face

  • Doctors treat malignant external otitis with antibiotics into your vein through a tube (IV)

The Outer Ear

What are the symptoms of malignant external otitis?

Symptoms include:

  • Severe ear pain

  • Thick, bad smelling fluid draining from your ear

  • Hearing loss

How can doctors tell if I have malignant external otitis?

Doctors will do a computed tomography (CT) scan to look for infection in the bone around your ear. They’ll also take samples of tissue and fluid from your ear to find out what types of bacteria are causing your infection.

How do doctors treat malignant external otitis?

You may need to stay in the hospital at first. Doctors will:

  • Give you antibiotics by vein through a tube (IV)

  • Clean out your ear canal

  • Sometimes, do surgery to remove badly infected bone

Because the infection is in the bone, you'll need to get IV antibiotics for about 6 weeks. But after you start getting better, you can usually finish getting the antibiotics at home.

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