title: Invasive fungal and bacterial infections of the temporal bone.
abstract: OBJECTIVE
  Objectives were to highlight the importance of surgical therapy in treating invasive polymicrobial infections of the temporal bone, to discuss the importance of antifungal therapy, and to review the differential diagnosis of ear canal granulomatous disorders.
  
  
  METHODS
  Retrospective case review at a tertiary care medical center.
  
  
  METHODS
  A retrospective chart review of all patients diagnosed with invasive polymicrobial temporal bone infections was performed. Four patients were identified. All patients required surgical therapy for definitive management. All patients were followed for at least 1 year or until death.
  
  
  RESULTS
  Three of four patients had invasive fungi as pathogens. One patient had an occult squamous cell carcinoma. At the time of writing, one patient was free of disease, two were dead of disease, and one was alive with disease.
  
  
  CONCLUSIONS
  Invasive polymicrobial temporal bone infections can occur in immunocompromised patients and can possibly harbor an occult malignancy. Surgical debridement may be necessary to arrive at a correct diagnosis. Modified radical mastoidectomy with parenteral antibiotic therapy and other adjunctive measures may be necessary for disease resolution.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, Loyola University of Chicago, Maywood, Illinois, USA. smarzo@lumc.edu
authors.forename: Sam J
authors.initials: SJ
authors.lastname: Marzo
authors.forename: John P
authors.initials: JP
authors.lastname: Leonetti
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents; D000935:Antifungal Agents / Q000008:administration & dosage; D001228:Aspergillosis / Q000473:pathology / Q000601:surgery*; D001424:Bacterial Infections / Q000473:pathology / Q000601:surgery*; D001706:Biopsy; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000601:surgery; D004359:Drug Therapy, Combination / Q000008:administration & dosage; D004424:Ear Canal / Q000473:pathology / Q000601:surgery*; D004428:Ear Neoplasms / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006931:Hyperbaric Oxygenation; D008134:Long-Term Care; D008297:Male; D009894:Opportunistic Infections / Q000473:pathology / Q000601:surgery; D010032:Otitis Externa / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications / Q000628:therapy; D012189:Retrospective Studies; D013701:Temporal Bone / Q000473:pathology / Q000601:surgery*; D014057:Tomography, X-Ray Computed
chemical_list: D000900:Anti-Bacterial Agents; D000935:Antifungal Agents