Fungal suppurative otitis media: a rare case report

Abstract

A chronic inflammatory middle ear cleft syndrome also known as chronic otitis media (COM) results in the partial or total loss of the tympanic membrane and ossicles. The most common isolates in the majority of the investigations were Pseudomonas aeruginosa, Streptococcus pneumonia, and Staphylococcus aureus. Candida species and Aspergillus species were the uncommon isolates. In our study a 70-year-old woman who has been having left ear discharge for around 20 days and has a history of left chronic otitis media (COM) tubotympanic illness over the previous six months. On clinical examination of the left ear using otoscope, otomycotic debri in the outer ear canal was observed with a moderate sized perforation over the postero-superior and postero-inferior quadrants of tympanic membrane. Two swab samples were taken from the left ear discharge primarily for the microbiological investigations. The findings showed a predominance of fungal growth but no bacterial growth was observed. The patient was medically managed with 2% acetic acid wash and topical clotrimazole drops for 2 weeks and tablet itraconazole 200 mg BD for 4 weeks. The patient was symptomatically better after 4 weeks of treatment. Our case is unique of its type as fungal cause of CSOM is extremely rare.