Aspergillus spp. invasive external otitis: favourable outcome with a medical approach

E. Marchionni (1, 2) , P. Parize (1) , A. Lefèvre (3) , P. Vironneau (4) , M. E. Bougnoux (5, 6) , S. Poiree (3) , H. Coignard-Biehler (1) , S. E. Dewolf (1) , K. Amazzough (1) , F. Barchiesi (2) , V. Jullien (7) , Alexandre Alanio (8) , D. Garcia-Hermoso (9) , M. Wassef (10) , R. Kania (4) , O. Lortholary (11, 1, 9) , F. Lanternier (1, 9, 11)

1 Centre d'infectiologie Necker-Pasteur [CHU Necker]
2 UNIVPM - Università Politecnica delle Marche [Ancona]
3 Service de Radiologie et imagerie médicale [CHU Necker]
4 Service d'oto-rhino-laryngologie
5 Unité de Parasitologie-Mycologie, Service de Microbiologie [Hôpital Necker-Enfants-Malades, Paris]
6 BPF - Biologie et Pathogénicité fongiques
7 UPD5 - Université Paris Descartes - Paris 5
8 Laboratoire de Parasitologie-Mycologie [CHU Saint Louis, Paris]
9 CNRMA - Centre National de Référence des Mycoses invasives et antifongiques - Mycologie moléculaire
10 Hôpital Lariboisière, Department of Pathology, University of Paris 7 - Denis Diderot, Faculty of Medicine
11 Mycologie moléculaire

Aspergillus spp. invasive external otitis (IEO) is a rare infection. We performed a seven-year, single-centre retrospective study from 2007 to 2014 including all patients with proven Aspergillus spp. IEO. Twelve patients were identified. All patients had a poorly controlled diabetes mellitus and one underwent solid organ transplant. The most frequently isolated species was Aspergillus flavus (n = 10) and voriconazole was the first-line therapy in all cases, with a median length of treatment of 338.5 days (158-804 days). None of the patients underwent extensive surgery. The clinical outcome was excellent. However, otological sequelae were reported, including hearing impairment (n = 7) and facial palsy (n = 3).

Keywords: Aspergillus spp.; diabetes mellitus; Invasive; otitis; voriconazole

Domains: Life Sciences [q-bio]; Life Sciences [q-bio]; Human health and pathology; Infectious diseases; Life Sciences [q-bio]; Microbiology and Parasitology; Mycology

E. Marchionni, P. Parize, A. Lefèvre, P. Vironneau, M. E. Bougnoux, et al.. Aspergillus spp. invasive external otitis: favourable outcome with a medical approach. Clinical Microbiology and Infection, 2016, 22 (5), pp.434--437. ⟨10.1016/j.cmi.2015.12.027⟩. ⟨pasteur-01405210⟩