Pharmacie Centrale, CHU d'Angers, 49933 Angers, France.
Pharmacie Centrale, CHU d'Angers, 49933 Angers, France.
J Mycol Med. 2018 Jun;28(2):396-398. doi: 10.1016/j.mycmed.2018.03.009. Epub 2018 Apr 16.
Fungal otitis (otomycosis) is a common infection encountered by otolaryngologists. Nevertheless, its management can be challenging because of its high recurrence rate and of the limited therapeutic options. A 45-year-old woman suffered from recurrent otomycosis. The ineffectiveness of successive antibiotic cures and repeated topical treatments with nystatin and then with econazole cream led to perform microbiological analyses. Culture of ear swab grew Aspergillus niger. The use of a 1% voriconazole sterile solution previously validated for treatment of eye infections was considered after ensuring the absence of known ototoxic effects of the antifungal and of the excipients. The patient was advised to apply locally this voriconazole solution daily for 14 days (3 drops, 3-4 times a day). Full recovery was obtained at the end of the treatment, and no relevant side effects were noticed. More than one year after completion of therapy, there was no recurrence. Our observation shows that voriconazole 1% solution is an interesting option for treating otomycosis which failed to respond to usual therapeutic options. Further prospective studies are now warranted to confirm these findings.
真菌性耳炎（耳霉菌病）是耳鼻喉科医生常见的一种感染。然而，由于其高复发率和有限的治疗选择，其治疗可能具有挑战性。一位 45 岁的女性患有复发性耳霉菌病。连续使用抗生素治疗和反复局部使用制霉菌素和酮康唑乳膏均无效，因此进行了微生物分析。耳拭子培养出黑曲霉。在确保抗真菌药物和赋形剂无已知耳毒性作用后，考虑使用一种先前已被验证可用于眼部感染治疗的 1%伏立康唑无菌溶液。建议患者局部使用这种伏立康唑溶液，每天 14 天（3 滴，每天 3-4 次）。治疗结束时完全恢复，未观察到任何相关的副作用。治疗完成一年多后，没有复发。我们的观察表明，对于对抗真菌药物治疗无效的耳霉菌病，1%伏立康唑溶液是一种有趣的治疗选择。现在需要进一步的前瞻性研究来证实这些发现。
