Invasive aspergillus masquerading as chronic otitis externa: A case report and review of the literature

Document Type

Conference Proceeding

Publication Date

10-1-2010

Journal

Laryngoscope

Volume

120

Issue

SUPPL. 3

DOI

10.1002/lary.21206

Abstract

Objectives In select hosts fungal species may become invasive and opportunistic, resulting in severe morbidity and mortality. We report a rare case of invasive Aspergillus, diagnosed on initial presentation as chronic fungal otitis externa. Study Design Single case report and review of the literature. Methods An elderly gentleman's clinical course is presented and discussed. We review the pertinent etiology, clinical manifestations, histopathology, diagnosis, and treatment of this aggressive mycosis and its associated complications. Results After invasive mycosis was suspected by radiographic imaging, surgical exploration and biopsy confirmed Aspergillus species. The patient's treatment was modified to include amphotericin B lipid complex and the patient symptomatically improved, eventually demonstrating clinical resolution of further fungal disease. Conclusions The occurrence of invasive mycotic infections of the head and neck has been steadily increasing over the past several decades. Aspergillus, a less common but highly destructive species in acute disease, employs a variety of immunoevasive mechanisms to gain advantage over its host. A high level of clinical suspicion along with a prompt multidisciplinary team approach can help improve the outcome of afflicted patients. A combination of medical therapy, early and aggressive surgical intervention, and an understanding of the underlying immunologic competency of the patient is the best regimen to achieve effective treatment. Copyright © 2010 The American Laryngological, Rhinological, and Otological Society, Inc.

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