title: Aspergillus spp. invasive external otitis: favourable outcome with a medical approach.
abstract: Aspergillus spp. invasive external otitis (IEO) is a rare infection. We performed a seven-year, single-centre retrospective study from 2007 to 2014 including all patients with proven Aspergillus spp. IEO. Twelve patients were identified. All patients had a poorly controlled diabetes mellitus and one underwent solid organ transplant. The most frequently isolated species was Aspergillus flavus (n = 10) and voriconazole was the first-line therapy in all cases, with a median length of treatment of 338.5 days (158-804 days). None of the patients underwent extensive surgery. The clinical outcome was excellent. However, otological sequelae were reported, including hearing impairment (n = 7) and facial palsy (n = 3).
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France; Infectious Diseases Department, Marche Polytechnic University, Ancona, Italy.
authors.forename: E
authors.initials: E
authors.lastname: Marchionni
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Parize
authors.affiliation: Department of Radiology, Necker-Enfants Malades Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Lefevre
authors.affiliation: Department of Oto-Rhino-Laryngology, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Vironneau
authors.affiliation: Microbiology Laboratory, Necker-Enfants Malades Hospital, Paris Descartes University, Paris, France; Biology and Pathogenicity Unit, Institut Pasteur, Paris, France.
authors.forename: M E
authors.initials: ME
authors.lastname: Bougnoux
authors.affiliation: Department of Radiology, Necker-Enfants Malades Hospital, Paris, France.
authors.forename: S
authors.initials: S
authors.lastname: Poiree
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France.
authors.forename: H
authors.initials: H
authors.lastname: Coignard-Biehler
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France.
authors.forename: S E
authors.initials: SE
authors.lastname: DeWolf
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France.
authors.forename: K
authors.initials: K
authors.lastname: Amazzough
authors.affiliation: Infectious Diseases Department, Marche Polytechnic University, Ancona, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Barchiesi
authors.affiliation: Department of Pharmacology, Paris Descartes University, Sorbonne Paris Cité, Inserm U1129, Hôpital Européen Georges-Pompidou, Paris, France.
authors.forename: V
authors.initials: V
authors.lastname: Jullien
authors.affiliation: Parasitology-Mycology Laboratory, Lariboisière-Saint Louis Hospital, Paris, France.
authors.forename: A
authors.initials: A
authors.lastname: Alanio
authors.affiliation: Institut Pasteur, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France.
authors.forename: D
authors.initials: D
authors.lastname: Garcia-Hermoso
authors.affiliation: Department of Pathology, Faculty of Medicine, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Wassef
authors.affiliation: Department of Oto-Rhino-Laryngology, Lariboisière Hospital, Paris Diderot University, Paris, France.
authors.forename: R
authors.initials: R
authors.lastname: Kania
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France; Institut Pasteur, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France; Institut Pasteur, Unite de Mycologie Moleculaire, CNRS URA3012, Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Lortholary
authors.affiliation: Paris Descartes University, Infectious Diseases and Tropical Medicine Department, Necker Pasteur Infectious Diseases Centre, Necker-Enfants Malades Hospital, APHP, IHU Imagine, Paris, France; Institut Pasteur, Centre National de Référence Mycoses invasives et Antifongiques, Paris, France; Institut Pasteur, Unite de Mycologie Moleculaire, CNRS URA3012, Paris, France. Electronic address: fanny.lanternier@nck.aphp.fr.
authors.forename: F
authors.initials: F
authors.lastname: Lanternier
mesh_terms: D000328:Adult; D000368:Aged; D000935:Antifungal Agents / Q000627:therapeutic use; D001228:Aspergillosis / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D001230:Aspergillus / Q000145:classification / Q000302:isolation & purification*; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009336:Necrosis / Q000473:pathology*; D016377:Organ Transplantation / Q000009:adverse effects; D010032:Otitis Externa / Q000175:diagnosis* / Q000188:drug therapy / Q000382:microbiology / Q000473:pathology*; D012189:Retrospective Studies; D016896:Treatment Outcome; D065819:Voriconazole / Q000627:therapeutic use
chemical_list: D000935:Antifungal Agents; D065819:Voriconazole
keywords: Aspergillus spp.; diabetes mellitus; invasive; otitis; voriconazole