혈액투석 환자에서 발생한 진균성 악성 외이도염 1예

Malignant otitis externa (MOE) is an aggressive and fatal disease that can spread along the soft tissues and skull base. In most case, it is caused by Pseudomonas aeruginosa, and fungus is rarely involved. The clinical feature of fungal MOE is very similar to that caused by bacteria, and the diagnosis is only confirmed by deep tissue biopsy, not by swab culture. Therefore, the diagnosis is often difficult to establish. In individuals who initially do well on antimicrobial therapy but subsequently recrudesce or who are unresponsive to appropriate antimicrobial treatment, clinician’s suspicion of fungal MOE is important not to delay the definite treatment. We experienced a case of 70-year-old man on hemodialysis treatment, who had severe right otalgia and headache for several weeks. He initially did well on antimicrobial treatment but subsequently experienced recrudescence. Through deep tissue biopsy, he was diagnosed as fungal MOE. (J Clinical Otolaryngol 2013;24:94–99)