Necrotizing Otitis Externa Due to Scedosporium sp.: A Case Report

Necrotizing otitis externa (NOE) is a severe and potentially life-threatening infection of the external auditory canal, particularly affecting elderly diabetic or immunocompromised patients. Pseudomonas aeruginosa is the most frequently isolated pathogen. Among fungi, Aspergillus and Candida spp. are the most commonly implicated. Nevertheless, Scedosporium sp. has also emerged as a notable pathogen in NOE. We report the case of a 67-year-old woman with poorly controlled diabetes who presented with persistent right-sided otorrhea and otalgia, complicated by facial paralysis. Imaging revealed bone erosion consistent with NOE. Mycological analysis of ear swabs identified Scedosporium sp. This case highlights the importance of considering fungal pathogens in refractory cases of otitis externa, particularly in high-risk patients. It underscores the need for early mycological investigations to ensure appropriate antifungal therapy.