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[白色念珠菌引起的恶性外耳道炎]

[Malignant otitis externa caused by Candida albicans].

作者信息

Elayoubi Fahd, Lachkar Azeddine, Aabach Ahmed, Chouai Mohamed, Ghailan Mohamed Rachid

机构信息

Service d'Oto-Rhino-Laryngologie et Chirurgie Cervico-Faciale CHU Mohammed VI, Oujda, Maroc.

出版信息

Pan Afr Med J. 2016 Aug 22;24:322. doi: 10.11604/pamj.2016.24.322.6007. eCollection 2016.

Abstract

Malignant otitis externa is also referred to as skull base osteomyelitis. Pseudomonas aeruginosa is the most common offending pathogen. However, fungal origin is not uncommon. 80-year-old patient having persistent left earache since two months despite adequate treatment. Otologic examination showed signs of inflammation in the auricular pavilion, ear canal stenosis with granulomas and purulent otorrhea. CT scan showed a filled otomastoid, extensive inflammatory process affecting the pre-auricular and retro-auricular tissues and lysis of the tympanic bulla. Given the lack of improvement, mycological examination was performed which revealed the presence of Candida Albicans. Cases of malignant otitis externa caused by Candida albicans are rarely reported. Fungal origin should be suspected in patients who have negative bacteriological samples and no improvement despite adequate antibiotic treatment. It should be confirmed by sometimes multiple mycological samples. Malignant otitis externa caused by Candida albicans is a rare potentially mortal infection.

摘要

恶性外耳道炎也被称为颅底骨髓炎。铜绿假单胞菌是最常见的致病病原体。然而,真菌性起源也并不罕见。一名80岁患者尽管接受了充分治疗,但两个月来左耳持续疼痛。耳科检查显示耳廓有炎症迹象、耳道狭窄伴有肉芽肿和脓性耳漏。CT扫描显示乳突气房充满、广泛的炎症过程累及耳前和耳后组织以及鼓泡溶解。鉴于病情无改善,进行了真菌学检查,结果显示存在白色念珠菌。由白色念珠菌引起的恶性外耳道炎病例鲜有报道。对于细菌学样本阴性且尽管接受了充分的抗生素治疗仍无改善的患者,应怀疑真菌性起源。有时需要多次真菌学样本才能确诊。由白色念珠菌引起的恶性外耳道炎是一种罕见的、可能致命的感染。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/9184/5267919/4a14a9f645f6/PAMJ-24-322-g001.jpg

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