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Skull Base Osteomyelitis Caused by an Elegant Fungus
Sharafine Stephen1, Beula Subashini2, Regi Thomas3
1PG Registrar.
The Journal of the Association of Physicians of India
|October 13, 2016
Summary
Fungal infections of the skull base are rare, with bacteria typically causing malignant otitis externa. This case highlights a fatal invasive infection by Apophysomyces elegans, a fungus usually causing skin infections.
Area of Science:
- Mycology
- Infectious Diseases
- Otolaryngology
Background:
- Malignant otitis externa (MOE), a severe skull base osteomyelitis, is primarily bacterial.
- Fungal etiologies for MOE are exceptionally rare.
- Diabetes mellitus is a known risk factor for invasive fungal infections.
Observation:
- A middle-aged diabetic male presented with invasive skull base infection.
- The causative agent was identified as Apophysomyces elegans, a fungus from the Zygomycetes class.
- This fungus is typically associated with cutaneous and soft tissue infections.
Findings:
- The patient succumbed to the invasive skull base infection.
- This represents a rare instance of mortality due to Apophysomyces elegans invasive infection.
- Invasive infections by this fungal genus, particularly in the ear, are seldom reported.
Implications:
- This case underscores the potential for rare fungal pathogens to cause severe, life-threatening infections.
- Highlights the need for considering unusual etiologies in refractory or severe skull base infections, especially in immunocompromised patients.
- Expands the known spectrum of invasive disease for Apophysomyces elegans, emphasizing its potential pathogenicity beyond skin and soft tissues.
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