Abstract
Introduction: Aspergillus necrotizing otitis externa (NOE) is rare, often diagnosed late, and associated with severe complications.
Case Report: A 68-year-old diabetic woman presented with left otalgia and otorrhea which had progressed for 3 months. Initially managed as bacterial NOE, her condition worsened with the onset of headaches and the aggravation of the biological inflammatory syndrome. CT scan showed deep tissue involvement, petrous bone lysis, and cavernous sinus thrombosis. Biopsies identified Aspergillus oryzae. Treatment with Voriconazole and anticoagulants led to clinical and biological improvement.
Conclusion: Fungal NOE should be considered in antibiotic-resistant cases to prevent serious complications such as cavernous sinus thrombosis.
Keywords: Necrotizing otitis externa, Aspergillus, Cavernous sinus
