Malignant otitis externa caused byMalassezia sympodialis

Abstract

Background Malignant otitis externa caused by fungal infections is rare. A review of the literature showed only 9 cases, and the causative fungus in all cases was Aspergillus. This article reports an unusual case caused by Malassezia sympodialis. Methods A 53‐year‐old man with non‐insulin dependent diabetes presented with malignant otitis externa. He deteriorated despite treatment with intravenous antipseudomonal therapy and surgical debridement. Microbiologic tests revealed M. sympodialis. He responded rapidly to intravenous amphotericin. Results Systemic human infections caused by M. sympodialis have not been reported. M. furfur systemic infection is rare and has been associated lipid hyperalimentation by means of a central catheter. Only 1 other case of M. fungemia without these associated risk factors has been reported. Conclusions The first case of malignant otitis externa caused by M. sympodialis is presented. It highlights the difficulty of initial biologic diagnosis and the need for lipid‐enriched media to grow this fastidious organism. © 2000 John Wiley & Sons, Inc. Head Neck 22: 87–89, 2000.

A rare and sinister variant of a common ailment: Fungal malignant otitis externa

“…The most common pathogen identified is Pseudomonas aeruginosa and up until a decade ago fungal MOE was considered extremely rare (4,5). There are however a number of cases in the literature reporting fungal organisms causing MOE, including Asperigillus species (6-8), Candida parapsilosis (9), Candida ciferri, Pseudoallescheria boydii, Malassezia sympodialis and Scedosporium apiospermum (5,10). …”

A Repertoire of the Less Common Clinical Yeasts

“…from the auditory system, as in most cases it is part of the microbiota of the external ear canal [84]. However, one case of malignant otitis externa with Malassezia sympodialis in a diabetic patient has been reported, highlighting a potential pathogenic effect [85]. Similarly, Trichosporon species have more rarely been isolated from the auditory system and implicated in otomycoses (Table 1).…”