Asymptomatic mucormycosis of middle ear: An incidental finding during tympanoplasty

Abstract

Mucormycosis is a fungal infection, commonly affecting the paranasal sinuses. An aggressive invasive form of infection is common in people with uncontrolled diabetes and in immunocompromised people. Mucormycosis affecting temporal bone is a rare entity, most of the reported cases are of invasive disease in diabetic people. We report a case of mucormycosis of middle ear cavity which was found incidentally in a healthy nondiabetic woman while performing revision tympanoplasty for chronic suppurative otitis media.

Mucormycosis of the Middle Ear—A Report of a Rare Case

“…In Sabouraud dextrose agar, the fungus develops into fluffy white, gray, or brownish colonies in 1 to 7 days. 4 Potassium hydroxide (20%), Gomori's methenamine silver staining, hematoxylin and eosin staining, or periodic acid-Schiff staining are all options for direct microscopic investigation. They are typically described as broad ribbon-like aseptate hyphae with right angled branching.…”

“…Histopathologically, this infection is characterized by angioinvasion and tissue invasion. 4 Antifungal drugs, debridement to lower fungus burden and improve drug accessibility, and correction of neutropenia or other risk factors in patients with immunological deficiencies are the three components of treatment. 13 The standard antifungal for mucormycosis is amphotericin B in its traditional desoxycholate form at 1 to 1.5 mg/kg/d or in liposomal form.…”

“…Mucormycosis that was otherwise not causing any symptoms has been found in the middle ear incidentally in a patient during revision tympanoplasty in a nondiabetic patient. 4…”

Rhino-Cerebral Mucormycosis with Otologic Involvement

“…Mucormycosis of the ear is uncommon, and when it appears, it tends to affect the temporal bone and external ear [ 2 , 3 ]. We came across a case study of auricular mucormycosis, in which chronic otitis media with otalgia, otorrhea, and hearing loss had been reported whereas another case study reported narrowed and inflammatory external auditory canal with tympanic membrane perforation [ 4 , 5 ].…”

Ear mucormycosis. Initial manifestation of diabetes mellitus

“…El diagnóstico definitivo de mucormicosis se confirma tras el estudio histopatológico de la biopsia (6)(7)(8). En el cultivo realizado por microbiología en nuestro caso, se aisló Rhizomucor pusillus como patógeno causal.…”