Diabetic patients are less aware of infections secondary to the neuropathy involved and tend to present when infection has eaten up quite a bit. This was a case of a fiery looking external ear with inflammation that progressed quickly in the last two weeks resulting in restriction of right jaw movement. Fortunately the MRI finds no extension to involve the temporomandibular joint. This study shows active inflammation of the external ear, parotid gland and mastoid air cells with reactive cervical lymphadenopathy.

Importantly there is no intra cranial extension, dural sinus thrombosis or any form of meningitis / epidural abscess.