Aspergillus niger, an opportunistic filamentousfungus, wasidentified asthecause ofchronic unilateralotomycosis in a 55-year old, immunocompromised man who had been unresponsive toa varietyof treatment regimens. The patient presented with intermittent otalgia and otorrhea and with a perforation ofhis left tympanic membrane. A niger wasidentified inaculturespecimen obtainedfrom the patient'sleftear canal. In immunocompromised patients, it isimportant that the treatment ofotomycosis beprompt and vigorous, to minimize the likelihood of hearing loss and invasive temporal boneinfection.
Laryngeal cancer in patients younger than 30 years is uncommon. We present dataon thispopulation obtained from theNational Cancer Institute's Surveillance, Epidemiology, and EndResults (SEER) Program. We identified 99 patients in thisage group from the SEER 17 registry, which includes data submitted from 1973 through 2003. Thispopulation was madeupof52 females and47 males; mostwere white, and mostwere aged 25 to29 years. Malignancies of the glottis were the most common cancers, followed bysupraglotticlesions.The5-year relativesurvival rate waslowest among those aged 15to 19years-60.1%; 5-year relative survival among those aged 20to24 and25 to29 years was 87.7 and87.4%, respectively. Theetiology of squamous cell carcinoma (SCC) in children and adolescents remains uncertain, but in theadultpopulation, a history ofsmoking, drinking, andpoororal hygiene cannot beignored. Carcinoma of the larynx in youngpeople has been related tomalignant degeneration ofpapillomas and tocomplications ofradiotherapyforpapillomas. Infection with thehuman immunodeficiency viruspossibly accelerates the development of SCC in patients with significant riskfactors, presumably by impairing normal immune surveillance mechanisms.
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