{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T23:07:32Z","timestamp":1792624052359,"version":"4.5.0"},"reference-count":23,"publisher":"SAGE Publications","issue":"11","license":[{"start":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T00:00:00Z","timestamp":1647648000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Ear Nose Throat J"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To examine associations of laboratory and imaging data with diagnostic parameters of necrotizing otitis externa (NOE) and its severity, and to compare between bacterial and fungal infections.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Records of patients diagnosed with NOE during 2010\u20132018 at the Department of Otolaryngology, Head and Neck Surgery were reviewed retrospectively for demographics; disease characteristics; and laboratory, scintigraphy, and imaging results.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Of 48 patients with NOE, the mean age is 73\u00b111.6\u00a0years; 32 (67%) were males; 83% had diabetes mellitus. Common pathogens were pseudomonas (49%) and fungi (33%). Sensitivities of the technetium-scan (SPECT ratio \u22651.5), temporal bone computed tomography (CT), and gallium-scan (SPECT ratio \u22651.3) were: 78.7%, 48.8%, and 31.4%, respectively. Gallium-scan results correlated positively with CT bone involvement (p=0.002) and hospital length of stay (p=0.0014). C-reactive protein (CRP) level correlated with hospital length of stay (p=0.028) and positive technetium-scan results (p=0.012). Fungal infection had a higher technetium SPECT ratio (2.16 vs. 1.77, p=0.04), gallium SPECT ratio (1.4 vs. 1.2, p=0.02), longer duration of systemic treatment (87.4 vs. 37.9\u00a0days, p=0.014), and longer hospital length of stay (31.6 vs. 15.2\u00a0days, p=0.004) compared to non-fungal infection. Eight (17%) patients had responded poorly to treatment. Fungal pathogens, facial nerve paresis, extra-auricular, and bilateral disease were more prevalent among the non-responders.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The technetium scan has higher sensitivity than temporal bone CT for diagnosing NOE. The gallium scan and CRP correlated well with hospital length of stay. A high rate of fungal infection was found, with significantly higher technetium and gallium SPECT ratios and worse outcome compared to bacterial infection. Fungal NOE remains therapeutically challenging.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/01455613221080973","type":"journal-article","created":{"date-parts":[[2022,3,19]],"date-time":"2022-03-19T06:56:00Z","timestamp":1647672960000},"page":"NP644-NP650","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":8,"title":["Laboratory and imaging findings of necrotizing otitis externa are associated with pathogen type and disease outcome: A retrospective analysis."],"prefix":"10.1177","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1591-4046","authenticated-orcid":false,"given":"Itai","family":"Margulis","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raanan","family":"Cohen-Kerem","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Roitman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadar","family":"Gez-Reder","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariel","family":"Aviram","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sivan","family":"Bitterman-Fisher","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Kugelman","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilana","family":"Doweck","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery, Lady Davis Carmel Medical Center, and the Bruce Rappaport Faculty of Medicine, Technion - Israel Institute of Technology, Haifa, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2022,3,19]]},"reference":[{"key":"bibr1-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-009-1194-2"},{"key":"bibr2-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1002\/lary.21673"},{"issue":"12","key":"bibr3-01455613221080973","first-page":"2006","volume":"88","author":"Glynn F","year":"2006","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"bibr4-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001812"},{"key":"bibr5-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1002\/lary.1986.96.11.1193"},{"key":"bibr6-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.1991.01870180059012"},{"key":"bibr7-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1002\/lary.28411"},{"key":"bibr8-01455613221080973","first-page":"411","volume":"35","author":"Hardoff R","year":"1994","journal-title":"J Nucl Meidicine"},{"key":"bibr9-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1258\/0022215053222978"},{"key":"bibr10-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27526"},{"key":"bibr11-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1016\/j.diagmicrobio.2016.10.017"},{"key":"bibr12-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1177\/0194599815572097"},{"key":"bibr13-01455613221080973","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.D.02691"},{"key":"bibr14-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1097\/MNM.0000000000001187"},{"key":"bibr15-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000249"},{"key":"bibr16-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-006-0118-7"},{"key":"bibr17-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00858-2"},{"key":"bibr18-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001986"},{"key":"bibr19-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(08)70221-7"},{"issue":"12","key":"bibr20-01455613221080973","first-page":"863","volume":"94","author":"Mardassi A","year":"2016","journal-title":"Tunisie Medicale"},{"key":"bibr21-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa020191"},{"key":"bibr22-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000839"},{"key":"bibr23-01455613221080973","doi-asserted-by":"publisher","DOI":"10.1177\/000348940111000415"}],"container-title":["Ear, Nose &amp; Throat Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613221080973","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/01455613221080973","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/01455613221080973","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T18:36:20Z","timestamp":1777401380000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/01455613221080973"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,3,19]]},"references-count":23,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2024,11]]}},"alternative-id":["10.1177\/01455613221080973"],"URL":"https:\/\/doi.org\/10.1177\/01455613221080973","relation":{},"ISSN":["0145-5613","1942-7522"],"issn-type":[{"value":"0145-5613","type":"print"},{"value":"1942-7522","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,3,19]]}}}