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Perichondritis of the auricle: bacterial or fungal? (A case series)
Background:
Suppurative perichondritis of the auricle is a common disease that can easily cause malformations if it develops into an uncontrolled infection. In nearly half of the cases, otolaryngologists cannot identify the pathogens involved.
Case Presentation:
In the present work, we described two cases of pyogenic perichondritis, with negative on conventional culture. However, using metagenomic next-generation sequencing (mNGS), we detected fungal infections in the patients and after the patients were given anti-fungal treatment, the patients achieved a good prognosis.
Conclusions:
These cases highlighted the possibility that fungi might be the involved pathogens in patients who have had multiple negative bacterial cultures, and mNGS should be applied in these cases. mNGS could be used as a supplement to traditional culture methods.
Insights
Fungal infections can cause suppurative perichondritis when bacterial cultures are negative. Metagenomic next-generation sequencing (mNGS) identified fungi, leading to successful antifungal treatment and improved patient outcomes.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Mycology
Background:
- Suppurative perichondritis of the auricle is a common condition with potential for severe malformations.
- Identifying causative pathogens remains challenging, with conventional cultures often yielding negative results in nearly half of cases.
Purpose of the Study:
- To investigate the utility of metagenomic next-generation sequencing (mNGS) in diagnosing difficult cases of pyogenic perichondritis.
- To highlight the potential role of fungal pathogens in perichondritis with negative bacterial cultures.
Main Methods:
- Case report of two patients with pyogenic perichondritis.
- Conventional microbial cultures were negative for pathogens.
- Metagenomic next-generation sequencing (mNGS) was employed for pathogen detection.
Main Results:
- mNGS successfully identified fungal infections in both patients.
- Antifungal treatment led to a good prognosis and recovery in both cases.
Conclusions:
- Fungi should be considered as potential pathogens in perichondritis cases with recurrent negative bacterial cultures.
- Metagenomic next-generation sequencing (mNGS) serves as a valuable supplement to traditional culture methods for diagnosing challenging infectious diseases.
- Early application of mNGS can guide appropriate antifungal therapy, improving patient outcomes.
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