Fungal malignant otitis externa

Bowles, Philippe; Perkins, Victoria; Schechter, Eyal

doi:10.1136/bcr-2016-218420

Cited by 12 publications

(7 citation statements)

References 9 publications

(22 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Furthermore, this case report emphasizes that fungal MOE should be a diagnostic consideration in patients with MOE who are unresponsive to or relapse after antibiotic therapy. An empiric antifungal treatment may be justified in such cases [28].…”

Section: Discussionmentioning

confidence: 99%

Fungal Malignant Otitis Externa Involves a Cascade of Complications Culminating in Pseudoaneurysm of Internal Maxillary Artery: A Case Report

et al. 2019

View full text Add to dashboard Cite

Patient: Male, 66 Final Diagnosis: Pseudoaneurysm of internal maxillary artery secondary to fungal malignant otitis externa Symptoms: Epistaxis Medication: — Clinical Procedure: Functional endoscopic sinus surgery, endovascular embolization Specialty: Infectious Diseases Objective: Unusual clinical course Background: Pseudomonal infection is the most common cause of malignant otitis externa (MOE), which typically affects elderly diabetic patients. Fungi are a rare cause of MOE. MOE can be life-threatening if not recognized and treated promptly. It can result in a wide spectrum of complications, including skull-base osteomyelitis, cranial nerve palsy, cerebral venous thrombosis, and brain abscess. Pseudoaneurysm formation of the intracranial vessels is a life-threatening complication of MOE that is seldom reported in the literature. Case Report: We report the case of a 66-year-old diabetic man with MOE who was initially treated with antipseudomonal antibiotics after negative initial culture results. His MOE resulted in a cascade of complications, including facial nerve palsy, skull base osteomyelitis, and sigmoid sinus thrombosis, and culminated in left maxillary artery pseudoaneurysm formation resulting in massive epistaxis and hemodynamic instability. Endovascular embolization resulted in a successful obliteration of the pseudoaneurysm. A subsequent functional endoscopic sinus surgical (FESS) tissue biopsy confirmed Candida glabrata as the etiological agent. The patient was successfully treated with antibiotics and antifungal and anticoagulation therapy, and was discharged home in good condition. Conclusions: A high index of suspicion for the diagnosis of fungal MOE, particularly in intractable cases of MOE with negative initial cultures, should be maintained. Pseudoaneurysm formation is a life-threatening complication of MOE that is seldom reported in the literature and should be suspected in any patient with MOE who presents with epistaxis or intracranial bleeding.

show abstract

Section: Discussionmentioning

confidence: 99%

Fungal Malignant Otitis Externa Involves a Cascade of Complications Culminating in Pseudoaneurysm of Internal Maxillary Artery: A Case Report

et al. 2019

View full text Add to dashboard Cite

show abstract

“…We believe that the high rates of culture-negative specimens of MOE patients in other settings in Iran 29 as well as the notable delay before proper treatment of fungal otitis among immunocompromised elderly patients in previous studies due to misleading culture results justify our approach in not relying on culture studies before initiation of empiric antifungal therapy. 29,30,31…”

Section: Discussionmentioning

confidence: 99%

A Treatment Protocol for Management of Bacterial and Fungal Malignant External Otitis: A Large Cohort in Tehran, Iran

Hasibi¹,

Ashtiani²,

Zarandi³

et al. 2017

Ann Otol Rhinol Laryngol

View full text Add to dashboard Cite

show abstract

“…It has been suggested that the presence of fungal pathogens and/or pathogenicity of some including Aspergillus sp. is enhanced by disrupting bacterial flora in the course of recent or concurrent antibiotic treatment related to NOE [101,102]. F-NOE, in contrast to the acute invasive fungal infection of otologic tissues described in the preceding section, may represent more of a chronic form of tissue invasive disease.…”

Section: Fungal Necrotizing Otitis Externamentioning

confidence: 98%

“…Clinical features of fungal necrotizing otitis externa (F-NOE) are similar to NOE caused by bacteria, though F-NOE may represent a more aggressive form of NOE [100] with higher rates of seventh cranial nerve damage, and reduced 5 year survival compared to non-fungal NOE [101]. It has been suggested that the presence of fungal pathogens and/or pathogenicity of some including Aspergillus sp.…”

Section: Fungal Necrotizing Otitis Externamentioning

confidence: 99%

Idiopathic, Infectious and Reactive Lesions of the Ear and Temporal Bone

Magliocca

Vivas

Griffith

2018

Head and Neck Pathol

View full text Add to dashboard Cite

A number of infectious, inflammatory and idiopathic lesions develop within otologic tissues that may share similar clinical and/or microscopic features. This review first provides a working classification for otitis externa, and then otitis media and includes two recently described entities, eosinophilic otitis media and otitis media with ANCA-associated vasculitis. Next, the microscopic findings of a spectrum of otopathologic conditions are described, including post-inflammatory conditions such as tympanosclerosis and aural polyps, an overview of animate aural foreign body as well as iatrogenic aural foreign body reactions. Finally, a review of fungal disease affecting the ear with a brief synopsis of Candida auris, a recently described and virulent organism, is presented.

show abstract

Fungal malignant otitis externa

Cited by 12 publications

References 9 publications

Fungal Malignant Otitis Externa Involves a Cascade of Complications Culminating in Pseudoaneurysm of Internal Maxillary Artery: A Case Report

Fungal Malignant Otitis Externa Involves a Cascade of Complications Culminating in Pseudoaneurysm of Internal Maxillary Artery: A Case Report

A Treatment Protocol for Management of Bacterial and Fungal Malignant External Otitis: A Large Cohort in Tehran, Iran

Idiopathic, Infectious and Reactive Lesions of the Ear and Temporal Bone

Contact Info

Product

Resources

About