Aspergillus necrotizing otitis externa with temporomandibulozygomatic involvement.

Area of Science:

• Infectious Diseases
• Otolaryngology
• Medical Mycology

Background:

• Aspergillus necrotizing otitis externa (NOE) is a rare, severe infection often diagnosed late.
• Management strategies for NOE remain poorly defined in medical literature.

Observation:

• A case of Aspergillus flavus NOE with concurrent temporomandibular arthritis and osteomyelitis is presented.
• The patient had a history of diabetes mellitus and a Staphylococcal coinfection.

Findings:

• Diagnosis involved imaging-guided biopsy, histology, and cultures; serology was negative.
• Positron Emission Tomography-Computed Tomography (PET-CT) guided diagnosis and treatment cessation.
• Successful treatment involved surgical debridement and 3 months of antifungal therapy.

Implications:

• PET-CT can be a valuable tool for monitoring NOE treatment response and guiding therapy duration.
• Aggressive surgical management combined with appropriate antifungal therapy is crucial for favorable outcomes.
• Early diagnosis and multidisciplinary management are essential for Aspergillus NOE, especially in immunocompromised patients.