Challenges in Management of Uncommon Otologic Fungal Disease - a Case Series and Review of Literature.

The purpose of this study is to describe challenges in diagnosis and treatment of otologic fungal infections.; 2) Methods: Case series and literature review 3) Results: Three patients treated at Louisiana State University Health Sciences Center - Shreveport between November 2020 - November 2023 were identified with complicated fungal otitis externa requiring detailed radiologic and histopathologic workup to aid in diagnosis and management. 4) Conclusion: Diagnosis of otologic fungal infection is often complex due to similar presentation of more common pathogens, overlapping features among common fungal specimens, and limitations of available diagnostic methods. Patient factors, including diabetes with poor glycemic control, may further complicate this challenging disease. High index of clinical suspicion, collaboration between multidisciplinary teams is essential to differentiate between common and uncommon fungal ear infections. A combination of mechanical debridement, topical and/or systemic therapy, and longitudinal follow-up with otolaryngology and infectious disease teams is required for successful treatment.