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ICD Hub / Diseases of the ear or mastoid process (H60–H95) / AA02 - Malignant otitis externa
ICD-11

ICD-11 Codes
for AA02 - Malignant otitis externa
Teodor Jurukovski January 1, 1970
Fact checked by: Teodor Jurukovski
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Alternative Names and Clinical Descriptions

Malignant otitis externa, identified by the ICD-11 code AA02, is also referred to by several other clinical terms. These include necrotising otitis externa, necrotising external otitis, and malignant external otitis (MEO). In more advanced stages, it may be described as skull-base osteomyelitis or osteomyelitis of the skull. For patients, it can be understood as a severe ear infection that has spread into the surrounding skull base structures.

Understanding Malignant Otitis Externa

Malignant otitis externa (ICD-11 code AA02) is a severe and potentially life-threatening infection. It originates in the external ear canal and can aggressively spread into deeper tissues, affecting the temporal bone and the base of the skull. The most common causative agent is the bacterium Pseudomonas aeruginosa. This condition requires prompt medical attention due to its serious nature.

Factors Contributing to Malignant Otitis Externa

The primary cause of malignant otitis externa is typically an infection by the bacterium Pseudomonas aeruginosa. Several factors significantly increase an individual's risk of developing this severe condition. These include: * Diabetes mellitus, especially when poorly controlled, which impairs the immune response and blood vessel function. * A compromised immune system, which can be due to conditions such as HIV or treatments like chemotherapy. * Advanced age. Often, the infection begins as a persistent outer ear infection (otitis externa) that does not resolve and subsequently invades deeper tissues.

Diagnosing Malignant Otitis Externa

The diagnosis of malignant otitis externa, coded as AA02 in ICD-11, relies on a comprehensive approach. This includes a thorough clinical evaluation, laboratory tests, and advanced imaging. Healthcare professionals will examine the ear for characteristic signs of infection and may obtain cultures of ear secretions to identify the specific pathogen, often Pseudomonas aeruginosa. Imaging studies, such as CT scans and MRI scans of the head, are essential for determining the extent of bone erosion and spread to the skull base. Pathological examination of granulation tissue from the infected site can also aid in diagnosis.

Managing Malignant Otitis Externa

Treatment for malignant otitis externa (AA02) is typically a lengthy and intensive process, often spanning several months. The primary objective is to eliminate the infection and prevent further complications. Key management strategies include: * Aggressive antibiotic therapy, administered intravenously and/or orally, to target the causative bacteria, particularly Pseudomonas aeruginosa. * Surgical debridement to remove any necrotic or infected tissue from the ear canal. * In more severe or extensive cases, surgical intervention may be necessary to clear dead or damaged bone in the skull. For patients with diabetes, maintaining optimal glucose control is a critical component of management.

Documentation and Coding for Malignant Otitis Externa

Accurate documentation and coding are vital for malignant otitis externa. The official ICD-11 code for this condition is AA02. When documenting, healthcare providers should clearly specify the affected ear (e.g., right, left, or bilateral) and any identified causative organisms. Common clinical synonyms such as necrotising otitis externa or skull-base osteomyelitis should be noted. For billing and reporting purposes, ensuring the correct ICD-11 code AA02 is used is essential for accurate reimbursement and tracking of this serious condition.

Recognizing When to Seek Medical Attention

Individuals experiencing symptoms suggestive of malignant otitis externa should seek immediate medical attention. Key indicators include persistent, severe ear pain, particularly if it is deep-seated and intensifies at night. Other concerning signs are foul-smelling, purulent ear discharge that does not improve with typical treatments, significant hearing loss, or the development of facial weakness. If symptoms of this severe ear infection arise or persist despite initial care, consulting a healthcare professional is crucial for timely diagnosis and management.

Frequently asked questions

What is the ICD-11 classification meaning of Malignant otitis externa (AA02)?
Malignant otitis externa (AA02) is a rare, life-threatening infective complication of otitis externa. It involves the penetration of organisms from the external ear canal into surrounding deeper tissues, leading to osteomyelitis of the temporal bone, and carries risks of damage to adjacent cranial nerves and septic thrombo-emboli to the brain. It is caused in the majority of cases by Pseudomonas aeruginosa.
How can the laterality of Malignant otitis externa be specified in ICD-11 coding?
Malignant otitis externa can be specified by laterality using post-coordination. Available categories include unilateral unspecified, left, right, and bilateral.
Can the infectious agent be specified for Malignant otitis externa in ICD-11?
Yes, the infectious agent responsible for Malignant otitis externa can be specified through post-coordination in ICD-11 coding.
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