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Otomycosis caused by the cryptic and emerging species Aspergillus sydowii: two case reports

Maria Ds Buonafina-Paz1, Franz Ag Santos1, Melyna C Leite-Andrade1

  • 1Federal University of Pernambuco, Recife, Pernambuco, 50670901, Brazil.

Future Microbiology
|November 16, 2022
PubMed

Insights

Two cases of otomycosis caused by Aspergillus sydowii were reported in patients post-tympanomastoidectomy. Early identification and susceptibility testing are crucial for managing this recurrent fungal infection in surgical patients.

Area of Science:

  • Otorhinolaryngology
  • Mycology
  • Infectious Diseases

Background:

  • Otomycosis, a fungal infection of the ear, poses challenges, particularly in post-surgical patients.
  • Chronic otitis media and anatomical variations can predispose individuals to ear infections.

Observation:

  • Two patients undergoing tympanomastoidectomy developed otomycosis.
  • Initial symptoms included otalgia, pruritus, and otorrhea, with underlying conditions like chronic otitis media and cholesteatoma.
  • Microscopic examination revealed septate hyphae, later identified as Aspergillus sydowii via BenA and CaM gene sequencing.

Findings:

  • Aspergillus sydowii was identified as the causative agent in both cases.
  • Antifungal susceptibility testing indicated low minimum inhibitory concentrations (MIC) for amphotericin B, itraconazole, ketoconazole, and ciclopirox olamine.
  • Both patients were treated with ketoconazole for 10 days.

Implications:

  • This study highlights Aspergillus sydowii as an emerging pathogen in otomycosis post-surgery.
  • Accurate identification and antifungal susceptibility testing are vital for understanding the epidemiological profile and guiding treatment.
  • Recurrent otomycosis in surgical patients necessitates careful management and pathogen surveillance.
Keywords:
Aspergillus section Nidulantesemerging speciesfungal otitisminimum inhibitory concentrationmycological diagnosistreatment

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