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[Otomastoiditis caused by Aspergillus in AIDS]

A Martínez-Berriotxoa1, M Montejo, K Aguirrebengoa

  • 1Unidad de Enfermedades Infecciosas, Hospital de Cruces, Barakaldo, Bizkaia.

Enfermedades Infecciosas Y Microbiologia Clinica
|April 1, 1997
PubMed
Summary

Aspergillus otomastoiditis is a rare fungal infection in immunocompromised individuals, particularly those with acquired immunodeficiency syndrome (AIDS). Early diagnosis and aggressive treatment are crucial for better outcomes in these patients.

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Area of Science:

  • Infectious Diseases
  • Otolaryngology
  • Mycology

Background:

  • Aspergillus otomastoiditis is an uncommon infection, primarily affecting immunocompromised individuals.
  • While fungal infections are prevalent in patients with acquired immunodeficiency syndrome (AIDS), documented cases of Aspergillus otomastoiditis are scarce.

Observation:

  • Two cases of Aspergillus otomastoiditis in AIDS patients are presented, with clinical presentations mimicking other otologic diseases.
  • The infections were associated with profound immunosuppression, specifically within the C3 group.

Findings:

  • Common symptoms include otorrhea, otalgia, hearing loss, and facial nerve paralysis.
  • Radiological imaging (CT/MRI) is essential for assessing disease extent, including potential bone destruction and intracranial invasion.

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  • Diagnosis requires histopathological confirmation or fungal isolation, as Aspergillus can be a commensal organism in the external auditory canal. Concurrent infections can impede diagnosis.

    • Implications:

    • Aggressive surgical debridement and systemic antifungal therapy (e.g., amphotericin B, itraconazole) are the primary treatment strategies.
    • Poor outcomes are often linked to disease severity, delayed diagnosis, and challenges in surgical management of immunocompromised patients.
    • In AIDS patients, a low CD4 cell count correlates with invasive Aspergillus infections and a poorer prognosis.