AUTHOR=Wang Qi , Hu Rui , Zhu YiFan , Zhu WenQing , Jiang Hua 

TITLE=Case Report: The application of metagenomic next generation sequencing in diagnosing fungal malignant external otitis: a report of two cases

JOURNAL=Frontiers in Cellular and Infection Microbiology

VOLUME=13

YEAR=2023

URL=https://www.frontiersin.org/journals/cellular-and-infection-microbiology/articles/10.3389/fcimb.2023.1236414

DOI=10.3389/fcimb.2023.1236414

ISSN=2235-2988

ABSTRACT=<sec><title>Background</title><p>Most of malignant external otitis (MEO) cases reported in the literature are attributed to <italic>Pseudomonas aeruginosa</italic>. Fungal infections in MEO are also likely but extremely rare. And conventional microbiology tests is difficult to diagnose.</p></sec><sec><title>Case description</title><p>Two patients were diagnosed with Fungal malignant external otitis (FMEO) due to <italic>Aspergillus</italic> by metagenomic Next-Generation Sequencing (mNGS) and recovered after comprehensive treatment including operation and voriconazole. The antifungal treatment was delayed due to repeated cultures of secretions being negative and pathological examination showed granulation tissue proliferation with extensive neutrophil infiltration.</p></sec><sec><title>Conclusion</title><p>mNGS might be helpful for patients suspected with FMEO, especially when conventional microbiology tests were negative.</p></sec>