Otomycosis due to coccidioidomycosis.

Area of Science:

• Mycology
• Infectious Diseases
• Otolaryngology

Background:

• Otomycosis, a fungal infection of the ear, is typically caused by Aspergillus and Candida species.
• Infections due to dimorphic fungi like Coccidioides immitis are exceptionally rare, especially in the ear canal.
• Coccidioides immitis is known for causing systemic fungal infections, often through reactivation of dormant foci.

Observation:

• Two novel cases of otomycosis caused by Coccidioides immitis, a fungus not previously reported to cause this condition, are presented.
• Both patients exhibited infections likely resulting from the reactivation of disseminated fungal foci.

Findings:

• Successful treatment involved a multimodal approach including local and systemic chemotherapy, surgical intervention, and management of the host immune response.
• One patient with systemic lupus erythematosus required intensified treatment, including more extensive surgery, chemotherapy, and reduced steroid dosage.

Implications:

• These findings highlight the necessity of a combined surgical and chemotherapeutic strategy for otomycosis caused by invasive fungi like Coccidioides immitis.
• Host immune status significantly influences disease progression and treatment outcomes in invasive fungal ear infections.