External Ear infections in diabetics- Challenges in management

Infections tend to occur more commonly and with more severity in people with diabetes than in non diabetics. Local and systemic immunological defects are likely to be responsible for high infection rates in diabetics. Hyperglycaemia in poorly controlled diabetes provides a good environment for vast number of microorganisms including bacteria, virus and fungi. Moreover, active infection in diabetes poses difficulty in controlling diabetes, hence causing a vicious cycle of infection and hyperglycaemia. An infection, which is easily manageable in non diabetics may turn out be of a severity out of proportion than expected in diabetics. Incidence of certain ear infections like malignant otitis externa is disproportionately higher in diabetics and so is the difficulty encountered in managing these conditions. Also, as some infections in diabetics present in a subtle and atypical manner, prompt recognition of infection followed by appropriate medical or surgical intervention is necessary.