A Case Report of Complete Resolution of Auricular Mucormycosis in an 18-Month-Old Diabetic Child

Abstract

Background. One of the most rare but deadly types of infectious fungal infection is Mucormycosis. All the cases reported with this type of infection are immunocompromised individuals. The challenge of early detection and intervention makes it one of the high mortality rates among other infectious diseases. Case Report. We report an 18-month-old girl with undiagnosed diabetes presented with a very aggressive form of necrotic infection of the ear auricle with facial nerve palsy. Using a series of magnetic resonance imaging, antibiotics, and high clinical suspicion, a diagnosis was established, and the patient was sent to the operation theatre for surgical debridement. Monthly follow-ups showed improvement of the facial palsy, and a plan for artificial auricle is set to occur in the following months before the age of five. Discussion. Mucormycosis is considered a very fatal and aggressive infection that has a very high mortality rate in immunocompromised patients. Early detection of such cases with an array of magnetic resonance imaging (MRI) and computed tomography (CT) is crucial in early treatment. Early aggressive surgical debridement and empirical coverage of bacterial, viral, and fungal infections can also alleviate the chances of preventing any secondary infection to develop in such cases. Conclusion. A combination of antifungal, antibiotic, and antiviral with timely surgical intervention improved the patient with complete resolution of the facial nerve palsy and no further recurrence of the infection.

Auricular mucormycosis complicated by parotid abscess and facial paralysis: A very rare case report

“…Reviewing previously described otologic mucormycosis within the literature, only a few cases of auricular mucormycosis have been reported in the literature. Indeed, Aljehani M 12 reported in 2021 a case of an 18‐month‐old girl with undiagnosed diabetes presented with an aggressive form of auricular mucormycosis with facial nerve palsy that have fully recovered after a combination of antifungal, antibiotic, and antiviral with extensive surgical debridement. Kumar and Nishan 9 reported in 2015 a case of a mucormycosis of the external ear invading the temporal bone with associated facial palsy.…”

Auricular mucormycosis complicated by parotid abscess and facial paralysis: A very rare case report

“…Reviewing previously described otologic mucormycosis within the literature, only a few cases of auricular mucormycosis have been reported in the literature. Indeed, Aljehani M [11] reported in 2021 a case of an 18-month-old girl with undiagnosed diabetes presented with an aggressive form of auricular mucormycosis with facial nerve palsy that have fully recovered after a combination of antifungal, antibiotic, and antiviral with extensive surgical debridement. Kumar and Nishan [8] reported in 2015 a case of a mucormycosis of the external ear invading the temporal bone with associated facial palsy.…”

Mucocutaneous manifestations of COVID-19-associated mucormycosis: A retrospective cross-sectional study

“…5 CEMRI findings like mild enhancing cutaneous and subcutaneous tissue were similar to changes described in few case reports. 13,14 Early initiation of amphotericin B, strict blood sugar control and surgical intervention may have halted our patient's disease progression to a severe necrotic stage.…”

“…Thus, we considered mixed infection to be the cause of malignant otitis externa in this patient since both Pseudomonas and Mucorales individually are known to cause malignant otitis externa but not in amalgamation, making it a unique presentation during the current pandemic with no such case reported to date. 14,17 Among 52 secondary cutaneous mucormycosis patients, only two had an ulcero-necrotic lesion on the face. 4,5 Out of these, one patient had associated malignant otitis externa of the left ear, a rare presentation.…”