A Unique Case of Purulent Malignant Otitis Externa Causing Community-Acquired Klebsiella Pneumonia Meningitis in a Marshallese Male

Abstract

Bacterial meningitis secondary to malignant otitis externa is a rare but dreaded complication. Malignant otitis externa typically results from infection with Pseudomonas aeruginosa. Community-acquired bacterial meningitis most commonly stems from Streptococcus pneumoniae or Neisseria meningitidis. We report a unique case of community-acquired Klebsiella pneumoniae meningitis, a rare culprit in the United States. Klebsiella pneumoniae disproportionally affects people of Southeast Asian descent. Dramatically increased rates of K. pneumoniae infection have been reported in Asian countries and in expatriates living abroad. Our case afflicted a 48-year-old man originally from the Marshall Islands residing in the United States. This case displays a unique constellation of anomalies and afflictions, including extension from MOE, bacteremia, facial nerve paralysis, dural sinus thrombosis, and rapid recovery.