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Th17 Inflammation Model of Oropharyngeal Candidiasis in Immunodeficient Mice
Published on: February 18, 2015
[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.
Abstract:
Malignant otitis externa is also referred to as skull base osteomyelitis. Pseudomonas aeruginosa is the most common offending pathogen. However, fungal origin is not uncommon. 80-year-old patient having persistent left earache since two months despite adequate treatment. Otologic examination showed signs of inflammation in the auricular pavilion, ear canal stenosis with granulomas and purulent otorrhea. CT scan showed a filled otomastoid, extensive inflammatory process affecting the pre-auricular and retro-auricular tissues and lysis of the tympanic bulla. Given the lack of improvement, mycological examination was performed which revealed the presence of Candida Albicans. Cases of malignant otitis externa caused by Candida albicans are rarely reported. Fungal origin should be suspected in patients who have negative bacteriological samples and no improvement despite adequate antibiotic treatment. It should be confirmed by sometimes multiple mycological samples. Malignant otitis externa caused by Candida albicans is a rare potentially mortal infection.
Insights
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.
