A Concomitant Allergic Fungal Otomastoiditis with an Allergic Fungal Rhinosinusitis

Abstract

Background: Allergic fungal otomastoiditis is a rare ear condition characterized by the presence of a specific middle ear mucus usually found in allergic bronchopulmonary aspergillosis. Methods: We report a case of concomitant allergic fungal otomastoiditis and rhinosinusitis in an immunocompetent 27-year-old man complaining of right otorrhea and nasal discharge for 6 months resistant to any medical treatment. Examination revealed a sticky mucus arising from a polypoid middle ear associated with a right middle meatus purulent discharge. Surgical treatment revealed no cholesteatoma but thick yellowish mucus and a fungal ball, as targeted by imaging, both of which containing Aspergillus species. Result: The patient received short postoperative systemic corticotherapy and showed no recurrence 6 months after. Discussion: Allergic fungal otomastoidis should be considered in the face of a sticky mucus arising from perforated chronic otitis, especially when associated with allergic fungal rhinosinusitis. Complete surgical debridement is essential.