Mucormycosis of the Middle Ear: A Case Report with Review of Literature

Abstract

Mucor is a saprophytic organism and commonly invades the nose and paranasal sinuses of immunocompromised and diabetic patients involvement of the middle ear and mastoid in a nondiabetic patients is very rare and this may be the first case report clinical presentation of ear pain with reference to the mastoid and upper neck may be the early symptoms unlike the foul smelling ear discharge as seen in atticoantral disease. Radical debridement in the form of M.R.M with or without the use of amphotericin B may suffice in non-diabetic patients this case is reported to highlight the point that mucormycosis can also involve middle ear and mastoid in nondiabetic patients.

Asymptomatic mucormycosis of middle ear: An incidental finding during tympanoplasty

“…[1] Very rarely, the infection can be seen affecting imunocompetent people. [6,7] There are five major forms of this which include rhinoorbitocerebral, pulmonary, disseminated, cutaneous, and gastrointestinal. [2] It can also cause some unusual infections like endocarditis, osteomyelitis, peritonitis, and pyelonephritis.…”

“…The debris was completely cleared during tympanoplasty, and patient had successful graft uptake, and on follow-up there was no complaints related to the operated ear. Hazarika et al, [6] in their report of a case, opined that mucormycosis in the middle ear in a nondiabetic patient is noninvasive and may occur as indolent infection which may coexist with chronic suppurative otitis media. In our case, this infection is possibly the cause of failure of tympanoplasty, but we do not have any evidence to prove this, as patient did not have any records of the previous surgery.…”

“…[4,5] There is only one reported case of mucormycosis of middle ear and mastoid in a nondiabetic person, who was treated by radical mastoidectomy. [6] We are reporting a case of mucormycosis of the middle ear in a middle aged lady, which was diagnosed incidentally while performing revision tympanoplasty for a failed tympanoplasty done for tubotympanic chronic suppurative otitis media.…”

Mucormycosis of the temporal bone with facial nerve palsy: A rare case report

“…With the use of Amphotericin B, incidence of morbidity and mortality associated with this life-threatening infection has come down significantly. [5] Three factors are key to a successful outcome of therapy for mucormycosis: [6] • Reversal of the underlying predisposition • Aggressive surgical debridement • Aggressive antifungal therapy with early initiation and high drug doses.…”

Temporal Bone Mucormycosis

“…To our knowledge, only 9 cases of mucormycosis of the temporal bone have been reported in the literature. [1][2][3][4][5][6][7][8][9] Of these 9, two were reported in non-immunocompromised patients, and 3 patients demonstrated facial nerve palsies. [3][4][5] We present the case of a 71-year-old woman with poorly controlled diabetes who presented with a seizure-like episode, otorrhea, and subsequent facial nerve weakness.…”