Abstract
Aspergillus mastoiditis and skull-base osteomyelitis are extremely rare, even in immunocompromised patients. We report a case of an 81-year-old immunocompetent man, who underwent a mastoidectomy because of unexplained, progressive otalgia in spite of a noninflamed and air-containing middle-ear space. Histopathology yielded Aspergillus fumigatus. When confronted with otitis with an unexpected clinical course a high index of suspicion is required to facilitate early diagnosis and appropriate therapy of a potential lethal Aspergillus infection, even in immunocompetent patients. This seems to be more so in older patients with an open middle-ear cavity and/or when there is facial nerve involvement.
MeSH terms
-
Aged, 80 and over
-
Antifungal Agents / administration & dosage
-
Aspergillosis / diagnosis*
-
Aspergillosis / immunology
-
Aspergillosis / pathology
-
Aspergillosis / surgery
-
Aspergillus fumigatus*
-
Diagnosis, Differential
-
Drug Therapy, Combination
-
Earache / etiology*
-
Humans
-
Immunocompetence*
-
Male
-
Mastoid / pathology
-
Mastoid / surgery
-
Mastoiditis / diagnosis*
-
Mastoiditis / immunology
-
Mastoiditis / pathology
-
Mastoiditis / surgery
-
Miconazole / administration & dosage
-
Postoperative Care
-
Pyrimidines / administration & dosage
-
Tomography, X-Ray Computed
-
Triazoles / administration & dosage
-
Tympanic Membrane Perforation / diagnosis
-
Tympanic Membrane Perforation / immunology
-
Tympanic Membrane Perforation / pathology
-
Tympanic Membrane Perforation / surgery
-
Voriconazole
Substances
-
Antifungal Agents
-
Pyrimidines
-
Triazoles
-
Miconazole
-
Voriconazole