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Necrotizing external otitis caused by Aspergillus fumigatus: computed tomography and high resolution magnetic

A Muñoz1, E Martínez-Chamorro

  • 1Departamento de Radiodiagnóstico, Hospital Universitario 12 de Octubre, Madrid, Spain.

The Journal of Laryngology and Otology
|May 15, 1998
PubMed

Insights

Necrotizing external otitis (NEO) typically affects diabetics and is caused by Pseudomonas. This study details an AIDS patient with NEO from Aspergillus fumigatus, highlighting extensive facial nerve involvement via MRI.

Area of Science:

  • Otolaryngology
  • Infectious Diseases
  • Radiology

Background:

  • Necrotizing (malignant) external otitis (NEO) is a severe infection predominantly seen in diabetic patients, usually caused by Pseudomonas aeruginosa.
  • Acquired immunodeficiency syndrome (AIDS) can predispose individuals to opportunistic infections, including fungal etiologies.

Observation:

  • A case of NEO in an acquired immunodeficiency syndrome (AIDS) patient is presented.
  • Computed tomography (CT) revealed destructive petrous bone involvement.
  • Magnetic resonance imaging (MRI) demonstrated extensive soft tissue and facial nerve compromise.

Findings:

  • The causative agent identified was Aspergillus fumigatus, an uncommon pathogen for NEO.
  • MRI provided detailed visualization of soft tissue and facial nerve involvement, surpassing CT capabilities.
  • This case highlights a distinct presentation of NEO in an immunocompromised host.

Implications:

  • Fungal infections like Aspergillus should be considered in the differential diagnosis of NEO, especially in immunocompromised patients.
  • Dedicated ear MRI is crucial for assessing the full extent of pathology, including soft tissue and cranial nerve involvement in NEO.
  • Understanding imaging findings in atypical NEO cases can improve diagnostic accuracy and treatment planning.

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