Aspergillus necrotizing otitis externa with temporomandibulozygomatic involvement.

European Annals of Otorhinolaryngology, Head and Neck Diseases
L NoroyJ Saison

Abstract

Aspergillus necrotizing otitis externa (NOE) is a rare disease, often associated with delayed diagnosis, the management of which is poorly defined. The authors report a case of Aspergillus flavus necrotizing otitis externa with temporomandibular arthritis and temporozygomatic osteomyelitis with Staphylococcal coinfection in a diabetic patient. The diagnosis and discontinuation of treatment were guided by PET-CT scan. A favourable course without sequelae was observed after repeated surgical curettage and 3 months of antifungal therapy. Aspergillus flavus is the agent most commonly incriminated in NOE. Indirect diagnostic tests (serology) may be negative. The diagnosis is based on imaging-guided surgical biopsy with histological examination and standard and fungal microbiological culture. Treatment requires a combination of surgery and antifungal therapy. The duration of antifungal therapy is poorly defined and discontinuation of therapy can be guided by PET-CT scan.

References

Mar 1, 1989·The Journal of Laryngology and Otology·H G Thomson
Dec 24, 2008·Antimicrobial Agents and Chemotherapy·Perrine ParizeOlivier Lortholary
Jan 24, 2016·Clinical Microbiology and Infection : the Official Publication of the European Society of Clinical Microbiology and Infectious Diseases·E MarchionniF Lanternier
Aug 3, 2016·Clinical Infectious Diseases : an Official Publication of the Infectious Diseases Society of America·Thomas F PattersonJohn E Bennett

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Citations

Oct 11, 2021·Journal of Stomatology, Oral and Maxillofacial Surgery·Milica JovanovićSlobodan Janković

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