Endocrine Abstracts

Background: Uncontrolled diabetes mellitus in ketoacidosis, as well as other kinds of metabolic acidosis, are major risk factors for mucormycosis. As the frequency of diabetes mellitus increase, so does the number of individuals at risk for this lethal infection. However, a lack of symptoms could lead to a delay in diagnosis. The aim of this paper is to study the clical features of otologic mucomycosis and to analysis the impact ketoacidosis the disease’s course.

Materials and methods: The zygomycete infection was confirmed by either or both histologically and mycological examination of specimens.

Result: Auricular mucormycosis was diagnosed in 4 patients. Patient ages ranged from 3 to 78 years, with a median age of 58.75 years. There were 3 (75 %) male subjects. The underlying diseases were kidney failure in one patient, cell-mediated immunity defect in another one and diabetes mellitus was noted in one case. No underlying condition was registred in one case. Auricular mucormycosis involved otocerebral (2 patients), chronic otitis media (1 patient) and malignant otitis externa (1 patient). Diagnosis was obtained by positive histology, positive direct microscopy and fungal culture in all patients. The species identified were Lichtemia corymbifere in two cases, Rhizopus arrhizus in one case, and Rhizopodiformis in the latter case. The quasi majority of antifungal-treated patients (3/4cases) received an amphotericin B formulation (amphotericin B deoxycholate in two cases and liposomal amphotericin B (L-AmB) in one case). Two (2/3) of these patients received amphotericin B in combination with other antifungals (fluconazole in one case and itraconazole in the other case). Mucormycosis was considered responsible for death in one patient.

Conclusion: Ketoacidosis is a significant factor in the development and in the control of this lethal infection. thereby it is important to optimalize information for clinicians in charge of diabetic patients.