A large number of complications can occur in a poorly controlled, long-standing condition of diabetes. A person with diabetes is prone to various infections. In ENT diseases, increased infections are the most frequent problem.
The most common infections, in general, are what we call the Upper Respiratory Infections. These are infections of the throat, sinuses and bronchi, which are usually viral, but rarely bacterial as well.
These infections tend to be recurrent in a diabetic and also require a longer time for the patient to recover.
These infections are characterised by a running nose or sore throat and fever followed by a cough, which may last from a few days to a few weeks. Ear infections, mainly what we call ‘middle ear infections’ are also more frequent in people with diabetes.
These occur when a throat or sinus infection spreads into the middle ear through a tube, called Eustachian tube.
Malignant Otitis Externa
There are two very severe infections occurring specifically in a diabetic person. Both of these are fortunately very rare, but once acquired can be quite disabling and life-threatening. One of these involves the external ear (what you routinely recognise as ear).
With a trivial injury or even without a recognisable injury, the ear gets acutely inflamed with a very high fever.
This is medically termed malignant otitis externa, malignant because it is so rapidly progressing. It is a bacterial infection, which calls for the use of potent antibiotics. It also spreads like fire and hence is difficult to treat.
Another typical infection, which is serious, affects sinuses. It is caused by a fungus and is called mucormycosis.
Fever is not a prominent feature of this infection. It usually starts in the nasal sinuses, where it affects the nasal cartilage.
Gradually, the cartilage turns dark and is destroyed, at a time causing holes in the cartilages. It also spreads to the palatal area, where it can deform the bone and create holes.