Review finds voriconazole the most common treatment for fungal necrotising otitis externa

Fungal cultures are recommended to support early diagnosis because many fungal species may not grow in initial swabs or routine culture. Image: Angellodeco/stock.adobe.com. Fungal necrotising otitis externa (NOE) can be difficult to diagnose and may need prolonged, multidisciplinary treatment, a review of studies shows....

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Clinicians managing necrotising otitis externa should consider requesting fungal cultures early in the diagnostic work-up rather than relying solely on routine swabs, as fungal species may not appear on standard testing; voriconazole is the most commonly reported antifungal treatment in the literature.

Fungal necrotising otitis externa is a life-threatening condition that is easily misdiagnosed when fungal cultures are omitted, and clearer treatment guidance could reduce morbidity in immunocompromised patients.

1. 01Review identifies voriconazole as the most frequently used antifungal treatment for fungal necrotising otitis externa.
2. 02Routine ear swabs often fail to detect the causative fungal species; dedicated fungal cultures are recommended.
3. 03Early fungal culture is advocated to guide accurate diagnosis and timely treatment.
4. 04Fungal necrotising otitis externa is a rare but potentially life-threatening ear canal infection, particularly in immunocompromised patients.
5. 05The review signals a need for standardised diagnostic protocols for this condition.

Publication type

review

Evidence level

2a

Population

Patients with fungal necrotising otitis externa (likely immunocompromised adults, based on typical disease epidemiology)

Intervention

Voriconazole and other antifungal treatments for fungal necrotising otitis externa