Objective: To investigate the clinical characteristics and outcome of fungal malignant external otitis (MOE). Methods: We report in this retrospective study, seven cases admitted to our infectious diseases department over a 5-year period (20072011), for a MOE. The diagnosis was based on a combination of clinical finding, biological and radiological investigations. Results: We identified one man and six women, all diabetics. The mean age was 63 years (5073 years). The main symptoms were severe otalgia (seven cases), otorrhoae (seven cases), oedema of the external ear canal (six cases) and headache (three cases). Three patients developed facial paralysis during disease progression. The pathogens identified on culture or PCR of ear samples were Aspergillus (two cases), Candida albicans (two cases), Candida parapsilosis (one case), Candida tropicalis (one case) and Candida kruseii (one case). All patients have bone erosion on computed tomography. After treatment by amphotericin or fluconazole or voriconazole, the evolution was favorable in five cases, one patient has persistent infection, and one patient died. Conclusion: Fungal malignant external otitis should be suspected in cases where there is no response to antipseudomonal antibiotic therapy. Samples and deep biopsies from the external ear canal are needed to confirm the diagnosis.
Full conference title:
22nd European Congress of Clinical Microbiology and Infectious Diseases
- ECCMID 22nd (2012)