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[Malignant otitis externa caused by Candida albicans]
Fahd Elayoubi1, Azeddine Lachkar1, Ahmed Aabach1
1Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale CHU Mohammed VI, Oujda, Maroc.
The Pan African Medical Journal
|February 4, 2017
Summary
Malignant otitis externa, a skull base osteomyelitis, can rarely be caused by Candida albicans. Fungal infections should be suspected in persistent cases unresponsive to antibiotics.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Mycology
Background:
- Malignant otitis externa (MOE), also known as skull base osteomyelitis, is typically caused by Pseudomonas aeruginosa.
- Fungal etiologies for MOE are less common but documented.
- Early and accurate diagnosis is crucial for effective management.
Observation:
- An 80-year-old patient presented with persistent left earache and otorrhea despite prior treatment.
- Otologic examination revealed inflammation, ear canal stenosis with granulomas, and purulent discharge.
- CT imaging demonstrated otomastoiditis with extensive inflammatory changes and tympanic bulla lysis.
Findings:
- Standard bacteriological investigations were negative.
- Subsequent mycological examination identified Candida albicans as the causative agent.
- This case highlights a rare instance of MOE originating from Candida albicans.
Implications:
- Fungal pathogens, particularly Candida albicans, should be considered in refractory cases of MOE.
- Negative bacterial cultures and lack of response to antibiotics warrant mycological investigation.
- Prompt identification and treatment of fungal MOE are critical due to its potentially fatal nature.
