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Invasive external otitis caused by Aspergillus
P Phillips1, G Bryce, J Shepherd
1Department of Medicine, Vancouver General Hospital, British Columbia, Canada.
Abstract:
Invasive external otitis occurs almost exclusively in patients with longstanding diabetes. Except for occasional cases, the etiologic agent has been Pseudomonas aeruginosa. We report a case caused by Aspergillus species in a diabetic patient with acute leukemia. Persistent infection was documented by culture and histology after a course of intravenous amphotericin B (total dose, 2 g). Clinical resolution occurred in association with a 3-month course of oral itraconazole. Four previously reported cases of invasive aspergillus otitis are reviewed.
Insights
Invasive otitis in diabetics is usually Pseudomonas aeruginosa. This case highlights Aspergillus species as a cause in a diabetic with leukemia, successfully treated with antifungals.
Area of Science:
- Infectious Diseases
- Mycology
- Otolaryngology
Background:
- Invasive external otitis (otomycosis) predominantly affects patients with long-standing diabetes mellitus.
- Pseudomonas aeruginosa is the most common causative agent, though fungal infections are occasionally reported.