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Abstract：
The aim of this report is to document a very rare case of Blastomycosis dermatitidis mastoiditis with extension into the retromastoid soft tissue and surrounding muscle. Blastomycosis dermatitidis is a dimorphic fungus of endemic areas which classically infiltrates the lungs; however, dissemination presenting as otomastoiditis is exceedingly rare. The patient was an immunocompetent 27-year-old male with no significant preexisting health conditions. He had significant work exposure to dust and soil and was referred to our department for evaluation of otalgia with headaches, hearing loss, and intermittent facial paralysis. Initially, the extent of the infection was unknown. Based on extensive disease on magnetic resonance imaging, the patient was scheduled for urgent tympanoplasty and mastoidectomy. Postoperative treatment with itraconazole resolved any further manifestations and halted further soft tissue invasion. It is important to consider uncommon fungal infections in the workup of persistent otalgia, especially when presenting with facial paralysis and a history of environmental exposure to soil and dust. This type of infection should be considered regardless of immunodeficiency status. Early detection may prevent hearing loss and local invasion into surrounding structures.
摘要：
本报告的目的是记录一例非常罕见的皮肤芽生菌病乳突炎，并延伸到乳突后软组织和周围肌肉。胚芽真菌病是流行区的双态真菌，典型地浸润肺部；然而，传播表现为耳乳突炎是非常罕见的。该患者是具有免疫能力的27岁男性，没有明显的先前存在的健康状况。他有大量的工作暴露在灰尘和土壤中，并被转介到我们的部门评估患有头痛的耳痛，听力损失,间歇性面瘫.最初，感染程度未知.基于磁共振成像的广泛疾病，患者被安排进行紧急鼓室成形术和乳突切除术。伊曲康唑的术后治疗消除了任何进一步的表现，并停止了进一步的软组织侵袭。重要的是在持续性耳痛的治疗中考虑罕见的真菌感染，尤其是当出现面瘫和环境暴露于土壤和灰尘的历史时。无论免疫缺陷状态如何，都应考虑这种类型的感染。早期检测可以防止听力损失和局部侵入周围结构。
