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Pseudomonas and Aspergillus interaction in malignant external otitis: risk of treatment failure

R Bovo1, A Benatti, A Ciorba

  • 1ENT-Ear Surgery Unit, Az. Ospedaliera, via Giustiniani 2, Padua, Italy. roberto.bovo@sanita.padova.it

Acta Otorhinolaryngologica Italica : Organo Ufficiale Della Societa Italiana Di Otorinolaringologia E Chirurgia Cervico-Facciale
|January 26, 2013
PubMed

Insights

Malignant external otitis (MEO) is a rare temporal bone infection. Prompt diagnosis is crucial, as Pseudomonas aeruginosa is often implicated, but fungal infections like Aspergillus can be missed, delaying critical treatment.

Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Mycology

Background:

  • Malignant external otitis (MEO) is a severe temporal bone infection.
  • Predominantly affects elderly, diabetic, or immunocompromised individuals.
  • Pseudomonas aeruginosa is the most common pathogen (>90% of cases).

Observation:

  • Recent increase in fungal and polymicrobial MEO cases.
  • A clinical case highlights a diagnostic pitfall.
  • Initial positive Pseudomonas findings delayed Aspergillus diagnosis.

Findings:

  • Delayed diagnosis of Aspergillus infection occurred.
  • Surgical debridement and biopsy were essential for correct diagnosis.
  • Bacteriological data can sometimes be misleading in MEO.

Implications:

  • Highlights the importance of considering non-bacterial pathogens in MEO.
  • Emphasizes the need for comprehensive diagnostic approaches beyond routine cultures.
  • Suggests potential for improved MEO treatment strategies by avoiding diagnostic delays.
Keywords:
AspergillusDiagnosis and prognosisNecrotizing otitis externa

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