Scedosporium apiospermum Otitis Complicated by a Temporomandibular Arthritis: A Case Report and Mini-Review.
Fiche publication
Date publication
octobre 2015
Journal
Mycopathologia
Auteurs
Membres identifiés du Cancéropôle Est :
Pr VILLENA Isabelle
Tous les auteurs :
Huguenin A, Noel V, Rogez A, Chemla C, Villena I, Toubas D
Lien Pubmed
Résumé
Scedosporium apiospermum is an ubiquitous fungus responsible for various infections in immunocompromised and immunocompetent patients. Ear infections are infrequent. We report an exceptional case of S. apiospermum external otitis complicated by temporomandibular joint arthritis. After 6 months of antibiotherapy, diagnosis was established by mycological analysis of external auditory canal and infratemporal fossae needle sampling. A satisfactory outcome was obtained after 2 months of voriconazole alone. We have reviewed 15 cases of S. apiospermum otitis. Seven of these patients were immunocompromised. Most common clinical presentation included a chronic external otitis lasting months or years before complication stage. Most common clinical features included recurrent unilateral otalgia (11/15) and purulent otorrhea (13/15). Diagnosis was often made at later stage (12/15) with local extension to bones and/or soft tissues (9/15) or cerebral lethal dissemination (3/15).The extremely low incidence of S. apiospermum otomycosis and its non-specific presentation results in a frequent diagnosis delay. A mycological investigation should be performed in case of persistent external otitis and/or osteolysis despite prolonged antibiotic treatment to prevent further extension of the disease.
Mots clés
Aged, 80 and over, Antifungal Agents, therapeutic use, Arthritis, etiology, Head, diagnostic imaging, Humans, Male, Mycoses, diagnosis, Otitis Externa, complications, Scedosporium, isolation & purification, Temporomandibular Joint, pathology, Temporomandibular Joint Disorders, diagnosis, Tomography, X-Ray Computed, Treatment Outcome, Voriconazole, therapeutic use
Référence
Mycopathologia. 2015 Oct;180(3-4):257-64