| Autor: |
Muraleedharan, Manjul, Keshri, Amit, Rao, Ram Nawal, Mehrotra, Anant, Das, Kuntal Kanti, Dubey, Abhishek, Hameed, Nazrin, Chidambaram, Kalyana Sundaram, Aqib, Mohd, Kumar, Raj, Manogaran, Ravi Sankar |
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| Zdroj: |
European Archives of Oto-Rhino-Laryngology; Mar2024, Vol. 281 Issue 3, p1221-1229, 9p |
| Abstrakt: |
Purpose: While extensive research with accurate classification has been done in mycoses of the paranasal sinuses and anterior skull base, a similar understanding of lateral skull base fungal pathologies is lacking due to relative rarity and diagnostic difficulties. We introduce a series of eleven cases and two different invasive entities of Aspergillus temporal bone diseases—fungal skull base osteomyelitis (SBO)/malignant otitis externa (MOE) and chronic invasive granulomatous fungal disease (CIGFD). Methodology: A retrospective observational study was conducted at the neuro-otology unit of a tertiary care referral center between July 2017 and November 2022. Diagnosed cases of lateral skull base osteomyelitis with atypical symptoms and lack of response to culture-directed antibiotics were evaluated for fungal origin. Patient data, including history, laboratory findings, serum galactomannan assay, CT and MRI imaging findings, clinical examination findings, and co-morbidities, were analyzed. The treatment course and response were assessed. Results: A total of 11 cases were included in the study. Of these, 9 were cases of Aspergillus-induced skull base osteomyelitis (SBO) and 2 of Aspergillus-induced chronic invasive granulomatous fungal disease (CIGFD). CIGFD presented with persistent ear discharge and slowly progressive post-aural swelling, while all patients of fungal SBO had lower cranial nerve palsies. CIGFD responded to excision and antifungals, while SBO responded well to conservative anti-fungal treatment. Conclusion: In cases of lateral SBO not responding to antibiotic therapy, the possibility of fungal etiology should be considered. Aspergillus spp. seems to be the major fungal pathogen. [ABSTRACT FROM AUTHOR] |
| Databáze: |
Complementary Index |
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