Fungal Malignant Otitis Externa: About Two Cases

Malignant Otitis Externa (MOE) is a rare but serious infection of the external auditory canal that can extend to the skull base, potentially leading to osteomyelitis and severe neurological complications. MOE occurs more frequently in older adults with diabetes mellitus and in immunocompromised individuals, such as those with HIV or cancer. The disease typically presents with symptoms such as severe otalgia, hearing loss, and purulent otorrhea. While MOE has traditionally been caused by bacterial infections, most commonly Pseudomonas aeruginosa there is an increasing incidence of fungal pathogens, which complicates both diagnosis and treatment. This condition is considered a medical emergency due to its potential for high morbidity and mortality, particularly when the infection involves cranial nerves or spreads to intracranial structures. Contributing factors to increased susceptibility in diabetic patients include poor tissue perfusion, immune dysfunction, and altered conditions within the external auditory canal.