2012
DOI: 10.1007/s12070-012-0527-4
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Fungal Otomastoiditis: A Case Series in Immunocompetent Adults

Abstract: Fungal otomastoiditis is a rare condition and is usually associated with host immunodeficiency. It is difficult to diagnose, and many cases are fatal. Treatment consists of surgical debridement, attempts to control the underlying immunological condition and antifungal chemotherapy. Individual case reports in immunocompetent patients have been published previously. We report a case series of seven with fungal otomastoiditis, all in immunocompetent patients.

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Cited by 11 publications
(9 citation statements)
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“…Fungal infections of the external ear canal (i.e., otomycosis) often coinfect with bacteria in cases of chronic otitis externa, particularly in the tropics (Conley, ; Reeh, ). Nevertheless, fungal infections rarely spread to affect bone tissue and in such cases cause a destructive rather than proliferative reaction in bone tissue (Conley, ; Hsu, Chen, & Wang, ; Reeh, ; Varghese, Nair, & Kavalakkat, ). Further, both males and females are at equal risk for developing otitis exerna (U.S. Centers for Disease Control and Prevention, ).…”
Section: Discussionmentioning
confidence: 79%
“…Fungal infections of the external ear canal (i.e., otomycosis) often coinfect with bacteria in cases of chronic otitis externa, particularly in the tropics (Conley, ; Reeh, ). Nevertheless, fungal infections rarely spread to affect bone tissue and in such cases cause a destructive rather than proliferative reaction in bone tissue (Conley, ; Hsu, Chen, & Wang, ; Reeh, ; Varghese, Nair, & Kavalakkat, ). Further, both males and females are at equal risk for developing otitis exerna (U.S. Centers for Disease Control and Prevention, ).…”
Section: Discussionmentioning
confidence: 79%
“…The most common fungal pathogens of otomastoiditis are Aspergillus species ( A. flavus and A. fumigatus ). Other fungal pathogens are Candida , Mucor , Blastomyces , Scedosporium apiospermum and Lecythophora hoffmannii . Most cases of Aspergillus species otomastoiditis were diagnosed in immunocompromised patients and treated with long‐term systemic antifungal therapy and surgical debridement .…”
Section: Discussionmentioning
confidence: 99%
“…The diagnosis of fungal otomastoiditis requires an experienced clinical suspicion. In patients who have prolonged otorrhoea, otalgia and progressive audio‐vestibular symptoms despite adequate antibacterial therapy, the possibility of fungal infection should be considered . Aspergillus fumigatus is considered the most common causative organism of fungal otomastoiditis .…”
Section: Introductionmentioning
confidence: 99%
“…mastoiditis is usually seen in an immunocompromised host, though few cases have been reported in immunocompetent hosts as well. 6,7 Cryptococcus neoformans as a cause of fungal mastoiditis is extremely rare and all cases reported till now have been in immunocompromised hosts; however to our knowledge, this is the first reported case in an immunocompetent individual. Recurrent otorrhoea and other signs and symptoms suggestive of mastoiditis, which are not responding to regular medical line of ABSTRACT treatment, should raise a high clinical suspicion in the minds of the surgeon and should include cryptococcal mastoiditis as a differential diagnosis in such cases.…”
Section: Fungalmentioning
confidence: 93%