ECE2020 Audio ePoster Presentations Diabetes, Obesity, Metabolism and Nutrition (285 abstracts)
Fungal necrotizing otitis externa in diabetic patients: Clinical features and diagnostic difficulties
Meherzi Abir 1,2 , Amal Kdissa 1,1 , Mouna Khalifa 1 , Monia Ghamam 2 , Mouna Bellakhdhar 1 , Kermani Wassim 1 & Abdelkefi Mohamed 2
1Sousse, ENT department Farhat Hached Hospital, Sousse, Tunisia; 2Sousse, ENT, Sousse, Tunisia
Objectives: To describe and analysis theimpact of diabetes on clinical presentation andthe difficulties we could affront within the management of this entity.
Materials and methods: A retrospective study conducted between 2006 and 2019 based on 24 patients managed at our Otolaryngology Head and Neck Surgery Department.
Results: 24 poorly controlled diabetic patients were enrolled in this study: 15 men and 9 women, with a mean age of 66 years. All patientspresented severe and persistent otalgia and otorrhea. External auditory canal narrowed:19 cases, granulation tissue 7 cases, polyp in 5 cases; facial nerve pulsy: 5 cases. Destruction of the bony meatus (79%), mastoid 25%; the obliteration of normal soft-tissue planes at the skull base 12,5%, the parapharyngeal extension 4% and the temporomandibular joint (4%) were documented by CT scans. Diagnosis was reviewed after a lack of response to antibiotic therapy it was established based on the Ear swabs for culture andhistopathologic. Aspergillus flavus (41%) and Candida (47%) were the fungal agents isolated. 2 patients were treated without identifying the causal fungus. Voriconazole was the first-line therapy, with a median length of treatment of 2 months. 2 patients underwent a mastoidectomy. The clinical outcome was favorable with 18 patients free of disease whose diabetes was controlled, otological sequelae were reported. 4 patients were not followed up.
Conclusion: It is a serious disease with high morbidity-mortality rate especially for poorly controlled diabetic patients. Underestimation of the entity may lead to a prolonged and ineffective treatment.
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Endocrine Abstracts
ISSN 1470-3947 (print) | ISSN 1479-6848 (online)
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