Complicated Necrotizing Otitis Externa Progressing to Coalescent Mastoiditis and Temporal Lobe Abscess

A 77-year-old man with a history of hypertension, chronic kidney disease, and poorly controlled type 2 diabetes mellitus presented to our intensive care unit from an outside hospital with complicated necrotizing otitis externa. One month prior, the patient developed purulent drainage from the right external auditory canal with associated hearing loss. One week prior, he was prescribed ciprofloxacin/dexamethasone otic suspension and oral ciprofloxacin tablets for his symptoms. Despite this regimen, he experienced progressive purulent otorrhea, along with subjective fevers, chills, headaches, and altered mental status.