Evidence map›Paper›PMID 39660747›Full record

ArticleThe journal of international advanced otology2024

Beyond the Ear, the Hidden Threat of Paecilomyces Neuro-Otological Infection: A Case Report.

Jing Hern Khoo, Izny Hafiz Zainon, Hafizah Husna Johari, Ida Sadja'ah Sachlin

Abstract readCase Reports
In one paragraph

Article in The journal of international advanced otology, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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4 · The record

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5 · Who and what money

Authors and funding

4 authors.

Jing Hern KhooDepartment of Otorhinolaryngology, Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
Izny Hafiz ZainonDepartment of Otorhinolaryngology, Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
Hafizah Husna JohariDepartment of Otorhinolaryngology, Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.
Ida Sadja'ah SachlinDepartment of Otorhinolaryngology, Head and Neck Surgery, Hospital Sultanah Bahiyah, Alor Setar, Kedah, Malaysia.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Paecilomyces spp. are thermo-tolerant fungi found in decaying vegetables and soil. They can cause ocular, cutaneous, and miscellaneous infections. In otorhinolaryngology, most infections occur in the paranasal sinuses, while otological infection is uncommon. Methods: We report a case of 41-year-old diabetic, male army officer with warm, fluctuant left temporal swelling and reduced hearing. Otoscopy revealed an edematous external auditory canal (EAC) with posterior wall sagging and bulging tympanic membrane. Computed tomography revealed subperiosteal temporal abscess extending intracranially. The pus was drained surgically via an otological and a neurosurgical approach, and pus sent for culture grew paecilomyces. He showed clinical improvement after receiving oral antifungal treatment postoperatively. Retrospectively, his occupation as an army officer and his diabetic immunocompromised state may have predisposed him to the infection. Results: Paecilomyces middle ear infection leading to intracranial involvement of such magnitude is yet to be reported, and we showcase its successful management through a combined surgical neuro-otology approach and oral antifungal therapy. Fungal ear infections can lead to severe extracranial and intracranial complications if inadequately treated. Differentiating it from cholesteatoma also presents a diagnostic challenge clinically and radiologically. While both can lead to intracranial complications, our patient's brief history and lack of prior ear symptoms contrast with that of cholesteatoma. Conclusion: The rarity of neuro-otological paecilomyces infections emphasizes the need for awareness and early identification. It is vital to recognize such infections, and prompt surgical management with appropriate antifungal drugs is warranted to prevent disastrous outcomes.

Indexed as

Antifungal AgentsPaecilomycesAdultHumansMaleMilitary PersonnelOtomycosisTomography, X-Ray ComputedAntifungal AgentsAbscessmastoiditisneurosurgeryotologypaecilomyces

Identifiers

PMID39660747
PMCPMC11639591

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