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Scedosporium apiospermum Otitis Complicated by a Temporomandibular Arthritis: A Case Report and Mini-Review

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Abstract

Scedosporium apiospermum is an ubiquitous fungus responsible for various infections in immunocompromised and immunocompetent patients. Ear infections are infrequent. We report an exceptional case of S. apiospermum external otitis complicated by temporomandibular joint arthritis. After 6 months of antibiotherapy, diagnosis was established by mycological analysis of external auditory canal and infratemporal fossae needle sampling. A satisfactory outcome was obtained after 2 months of voriconazole alone. We have reviewed 15 cases of S. apiospermum otitis. Seven of these patients were immunocompromised. Most common clinical presentation included a chronic external otitis lasting months or years before complication stage. Most common clinical features included recurrent unilateral otalgia (11/15) and purulent otorrhea (13/15). Diagnosis was often made at later stage (12/15) with local extension to bones and/or soft tissues (9/15) or cerebral lethal dissemination (3/15).The extremely low incidence of S. apiospermum otomycosis and its non-specific presentation results in a frequent diagnosis delay. A mycological investigation should be performed in case of persistent external otitis and/or osteolysis despite prolonged antibiotic treatment to prevent further extension of the disease.

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Acknowledgments

We thank Dr. Dea Garcia-Hermoso, National Reference Center for Mycoses and Antifungals (Institut Pasteur, Paris, France), for performing molecular identification. We thank Dr. P.L. Toubas for reviewing the manuscript.

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Authors and Affiliations

  1. Parasitology-Mycology Laboratory, 45 rue Cognacq-Jay, CHU Maison Blanche, 51100, Reims, France

    A. Huguenin, C. Chemla, I. Villena & D. Toubas

  2. Internal Medicine and Infectious Disease Unit, 45 rue Cognacq-Jay, CHU Robert Debré, 51100, Reims, France

    V. Noel & A. Rogez

  3. EA 3800, Université Reims Champagne-Ardenne, Reims, France

    I. Villena

  4. Equipe MéDIAN, Unité MEDyC CNRS UMR 7369, Université de Reims Champagne-Ardenne, Reims, France

    D. Toubas

  5. Laboratoire de Parasitologie Mycologie, CHU de Reims, Université Reims Champagne Ardenne, Hôpital Maison Blanche, 45 rue Cognacq Jay, 51092, Reims, France

    A. Huguenin

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  1. A. Huguenin
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Correspondence to A. Huguenin.

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Huguenin, A., Noel, V., Rogez, A. et al. Scedosporium apiospermum Otitis Complicated by a Temporomandibular Arthritis: A Case Report and Mini-Review. Mycopathologia 180, 257–264 (2015). https://doi.org/10.1007/s11046-015-9911-4

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  • DOI: https://doi.org/10.1007/s11046-015-9911-4

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