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Histoplasma tympanomastoiditis: Case report and literature review

Terrence Park1, Gordon Love1, Victoria Burke1

  • 1Louisiana State University Health Sciences Center Section of Infectious Diseases, 1542 Tulane Avenue, Suite 331C, New Orleans, LA 70112, USA.

Idcases
|May 15, 2023
PubMed

Insights

A rare case of Histoplasma capsulatum infection in the ear occurred in an immunocompetent patient. This fungal infection, typically affecting the lungs, was successfully treated with surgery and antifungals.

Area of Science:

  • Mycology
  • Infectious Diseases
  • Otolaryngology

Background:

  • Histoplasma is a dimorphic fungus causing varied human diseases based on immune status.
  • In immunocompetent individuals, Histoplasma infections usually manifest as pulmonary or nodal disease.
  • Extrathoracic manifestations are uncommon in immunocompetent hosts.

Observation:

  • A case of Histoplasma capsulatum tympanomastoiditis is presented.
  • The patient was immunocompetent and experienced worsening otorrhea, vertigo, and facial nerve palsy.
  • This represents a rare presentation of fungal infection in the middle ear and mastoid.

Findings:

  • Histoplasma capsulatum successfully infected the tympanomastoid region.
  • The patient presented with symptoms indicative of otologic and neurological involvement.
  • Diagnosis was confirmed, and treatment was initiated.

Implications:

  • This case highlights the potential for Histoplasma to cause unusual extrathoracic infections even in immunocompetent individuals.
  • It underscores the importance of considering fungal etiologies in complex otologic presentations.
  • Successful management involved a combination of surgical intervention and prolonged antifungal therapy, offering a potential treatment paradigm.
Keywords:
Fungal otomastoiditisHistoplasmosis

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