Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature
<h3>Background</h3><p dir="ltr">Malignant otitis externa (MOE) is a serious infection of the external auditory canal that is frequently associated with skull base osteomyelitis (SBO) as well as secondary neurological sequelae. Patients with poorly controlled diabetes mell...
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2021
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| _version_ | 1864513546379853824 |
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| author | Junais Koleri (17280586) |
| author2 | Ahmad Al Bishawi (14148810) Israa' Al-Sheikh (17302696) Salman Qureshi (407124) Muna AlMaslamani (12937049) Hamad Abdelhadi (14777857) |
| author2_role | author author author author author |
| author_facet | Junais Koleri (17280586) Ahmad Al Bishawi (14148810) Israa' Al-Sheikh (17302696) Salman Qureshi (407124) Muna AlMaslamani (12937049) Hamad Abdelhadi (14777857) |
| author_role | author |
| dc.creator.none.fl_str_mv | Junais Koleri (17280586) Ahmad Al Bishawi (14148810) Israa' Al-Sheikh (17302696) Salman Qureshi (407124) Muna AlMaslamani (12937049) Hamad Abdelhadi (14777857) |
| dc.date.none.fl_str_mv | 2021-05-18T00:00:00Z |
| dc.identifier.none.fl_str_mv | 10.1016/j.idcr.2021.e01163 |
| dc.relation.none.fl_str_mv | https://figshare.com/articles/journal_contribution/Beware_of_covert_enemies_Candida_orthopsilosis_malignant_otitis_externa_with_base_of_the_skull_osteomyelitis_a_case_report_and_review_of_literature/24459049 |
| dc.rights.none.fl_str_mv | CC BY 4.0 info:eu-repo/semantics/openAccess |
| dc.subject.none.fl_str_mv | Biomedical and clinical sciences Clinical sciences Malignant otitis externa MOE Candida orthopsilosis Osteomyelitis |
| dc.title.none.fl_str_mv | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| dc.type.none.fl_str_mv | Text Journal contribution info:eu-repo/semantics/publishedVersion text contribution to journal |
| description | <h3>Background</h3><p dir="ltr">Malignant otitis externa (MOE) is a serious infection of the external auditory canal that is frequently associated with skull base osteomyelitis (SBO) as well as secondary neurological sequelae. Patients with poorly controlled diabetes mellitus or immunosuppression are at increased risk of developing such critical infection for multiple local and systemic factors. While most cases are secondary to bacterial infections particularlyPseudomonas aeruginosa, fungal infections are also occasionally encountered, often associated with delayed diagnosis and high morbidity and mortality.</p><h3>Case report</h3><p dir="ltr">We report a case of a 63 years old man with uncontrolled diabetes mellitus who presented with symptoms and signs of MOE, supported by radiological assessments. The patient was treated presumptively with a prolonged course of antibiotics without clinical improvement, coupled with progression of radiological findings and significant disease extension. Reassessment with biopsies and tissue cultures from external auditory meatus, tempo-mandibular bone, as well as base of the skull grew Candida orthopsilosis. The patient received induction treatment with high dose liposomal amphotericin followed by fluconazole to control disease progression and complications.</p><h3>Conclusion</h3><p dir="ltr">Candida MOE with secondary skull base osteomyelitis is rare and difficult to diagnose with no clear guidance on assessment and management. Clinicians should be aware of the unusual presentations where microbiological and histopathological evaluations are essential for proper management.</p><h2>Other Information</h2><p dir="ltr">Published in: IDCases<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.idcr.2021.e01163" target="_blank">https://dx.doi.org/10.1016/j.idcr.2021.e01163</a></p> |
| eu_rights_str_mv | openAccess |
| id | Manara2_516fef996e34c64aaec136dc69010a00 |
| identifier_str_mv | 10.1016/j.idcr.2021.e01163 |
| network_acronym_str | Manara2 |
| network_name_str | Manara2 |
| oai_identifier_str | oai:figshare.com:article/24459049 |
| publishDate | 2021 |
| repository.mail.fl_str_mv | |
| repository.name.fl_str_mv | |
| repository_id_str | |
| rights_invalid_str_mv | CC BY 4.0 |
| spelling | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literatureJunais Koleri (17280586)Ahmad Al Bishawi (14148810)Israa' Al-Sheikh (17302696)Salman Qureshi (407124)Muna AlMaslamani (12937049)Hamad Abdelhadi (14777857)Biomedical and clinical sciencesClinical sciencesMalignant otitis externaMOECandida orthopsilosisOsteomyelitis<h3>Background</h3><p dir="ltr">Malignant otitis externa (MOE) is a serious infection of the external auditory canal that is frequently associated with skull base osteomyelitis (SBO) as well as secondary neurological sequelae. Patients with poorly controlled diabetes mellitus or immunosuppression are at increased risk of developing such critical infection for multiple local and systemic factors. While most cases are secondary to bacterial infections particularlyPseudomonas aeruginosa, fungal infections are also occasionally encountered, often associated with delayed diagnosis and high morbidity and mortality.</p><h3>Case report</h3><p dir="ltr">We report a case of a 63 years old man with uncontrolled diabetes mellitus who presented with symptoms and signs of MOE, supported by radiological assessments. The patient was treated presumptively with a prolonged course of antibiotics without clinical improvement, coupled with progression of radiological findings and significant disease extension. Reassessment with biopsies and tissue cultures from external auditory meatus, tempo-mandibular bone, as well as base of the skull grew Candida orthopsilosis. The patient received induction treatment with high dose liposomal amphotericin followed by fluconazole to control disease progression and complications.</p><h3>Conclusion</h3><p dir="ltr">Candida MOE with secondary skull base osteomyelitis is rare and difficult to diagnose with no clear guidance on assessment and management. Clinicians should be aware of the unusual presentations where microbiological and histopathological evaluations are essential for proper management.</p><h2>Other Information</h2><p dir="ltr">Published in: IDCases<br>License: <a href="http://creativecommons.org/licenses/by/4.0/" target="_blank">http://creativecommons.org/licenses/by/4.0/</a><br>See article on publisher's website: <a href="https://dx.doi.org/10.1016/j.idcr.2021.e01163" target="_blank">https://dx.doi.org/10.1016/j.idcr.2021.e01163</a></p>2021-05-18T00:00:00ZTextJournal contributioninfo:eu-repo/semantics/publishedVersiontextcontribution to journal10.1016/j.idcr.2021.e01163https://figshare.com/articles/journal_contribution/Beware_of_covert_enemies_Candida_orthopsilosis_malignant_otitis_externa_with_base_of_the_skull_osteomyelitis_a_case_report_and_review_of_literature/24459049CC BY 4.0info:eu-repo/semantics/openAccessoai:figshare.com:article/244590492021-05-18T00:00:00Z |
| spellingShingle | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature Junais Koleri (17280586) Biomedical and clinical sciences Clinical sciences Malignant otitis externa MOE Candida orthopsilosis Osteomyelitis |
| status_str | publishedVersion |
| title | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| title_full | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| title_fullStr | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| title_full_unstemmed | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| title_short | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| title_sort | Beware of covert enemies: Candida orthopsilosis malignant otitis externa with base of the skull osteomyelitis, a case report and review of literature |
| topic | Biomedical and clinical sciences Clinical sciences Malignant otitis externa MOE Candida orthopsilosis Osteomyelitis |