Fungal malignant external otitis

Fungal malignant otitis externa

“…The most commonly associated causative micro-organism is Pseudomonas aeruginosa , although cases of Staphylococcus epidermis , Proteus mirabilis and Klebsiella oxytoca have also been reported 5. Fungal infection is increasingly recognised as a cause of MOE with C. albicans and Aspergillus species the most commonly implicated micro-organisms 5 6.…”

“…Fungal infection is increasingly recognised as a cause of MOE with C. albicans and Aspergillus species the most commonly implicated micro-organisms 5 6. Fungal and bacterial culture may be negative at initial presentation3 5 with positive culture arising only later in the treatment process. It has been suggested that fungal pathogens result as an opportunistic infection, due to prolonged intravenous antibiotic treatment of a primary bacterial MOE 5.…”

Clinical Utility of a Polymerase Chain Reaction Assay in Culture-Negative Necrotizing Otitis Externa

“…Hamzany et al (4) described their experience with fungal NOE and concluded that this subgroup of patients usually present a more invasive disease nature. This observation is consistent with our results as we find fungal disease refractory to conventional treatments.…”

“…However, fungal NOE is described more often (4), and this may be correlated with a rise in the numbers of newly diagnosed diabetic patients that was previously offered as a cause for this effect (5). It has been suggested that fungal cases may be secondary to prolonged antibiotic treatment (6).…”

Freshwater Fungal Infections

“…It is generally seen in diabetics or immunocompromised persons following prolonged antibiotic treatment for bacterial malignant otitis externa (without a reported link to freshwater exposure). 44 …”