INTRODUCTION

Very few cases of Scopulariopsis brevicaulis otitis have been reported. Therefore, no generalized clinical guideline for the diagnostic and therapeutic approach exists. Here, we report the clinical outcome of a patient with Scopulariopsis otitis, summarize previous case reports, and elucidate treatment options.

MATERIALS AND METHODS

A case report is presented, including treatment strategy. In addition, a comprehensive literature review was performed using Pubmed and all previously published cases of Scopulariopsis brevicaulis were reviewed and summarized.

RESULTS

CASE REPORT
A 26-year-old, immunocompetent male with chronic Eustachian tube dysfunction simultaneously developed a cholesteatoma and fungal overgrowth of the right ear in September 2019. Empiric treatment with miconazole ear drops suppressed symptoms, so type-III-tympanoplasty became feasible. Ten months later, he reported otorrhea. Two swabs were taken, and in the intraoperative one, Scopulariopsis brevicaulis was isolated. Topical treatment with 1% voriconazole solution cured the patient. LITERATURE REVIEW
Finnish researchers reported 7 cases of S. brevicaulis. Ear infections responded to local treatment with antiseptic drugs and mechanical cleansing with symptom relief.
In 1994 Hennequin et al. cured Scopulariopsis brevicaulis otomycosis following tympanoplasty using nystatin. Similarly, Besbes et al. used nystatin complementing cholesteatoma surgery. De Miguel-Martinez used voriconazole in 2018.

CONCLUSION

Scopulariopsis has a striking intrinsic resistance to most antifungal drugs. Therefore, resistance testing is imperative. Lipid formulations of amphotericin B and itraconazole are often recommended. Nystatin was used successfully. Azole antimycotics present a newer treatment option.

Die Autorinnen/Autoren geben an, dass kein Interessenkonflikt besteht.