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She rapidly progressed to total necrosis of the tympanic membrane. Further assessments confirmed a fungal disease caused by <jats:styled-content style=\"fixed-case\"><jats:italic>Candida tropicalis<\/jats:italic><\/jats:styled-content> and <jats:italic>Aspergillus flavus<\/jats:italic>. Immediate antifungal therapy with amphotericin B and subsequent radical mastoidectomy managed to control the disease with no sign of necrosis after 3\u2009months. Early diagnosis, aggressive systemic antifungal treatment, and surgical debridement are vital components for successful management of such cases.<\/jats:p>","DOI":"10.1002\/ccr3.70101","type":"journal-article","created":{"date-parts":[[2025,1,21]],"date-time":"2025-01-21T02:24:25Z","timestamp":1737426265000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Unusual Presentation of a Rare Disease: A Case Report of Fungal Necrotizing Otitis Media and Mastoiditis"],"prefix":"10.1002","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0088-2587","authenticated-orcid":false,"given":"Ermia","family":"Mousavi Mohammadi","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology, Sinus and Surgical Endoscopic Research Center, School of Medicine Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0168-6062","authenticated-orcid":false,"given":"Mohsen","family":"Rajati","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology, Sinus and Surgical Endoscopic Research Center, School of Medicine Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1449-4668","authenticated-orcid":false,"given":"Hossein","family":"Zarrinfar","sequence":"additional","affiliation":[{"name":"Allergy Research Center Mashhad University of Medical Sciences  Mashhad Iran"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,1,20]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0044-101327"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.18203\/issn.2454-5929.ijohns20202801"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/019459988609400522"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1046\/j.1439-0507.2003.00835.x"},{"issue":"1","key":"e_1_2_12_6_1","first-page":"331","article-title":"Molecular Identification of Candida Species in Bronchoalveolar Lavage Specimens of Hospitalized Children With Pulmonary Disorders","volume":"23","author":"Kashefi E.","year":"2021","journal-title":"Journal of Babol University of Medical Sciences"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11046-021-00563-z"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.5152\/iao.2023.22743"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.3109\/08880019809016578"},{"issue":"5","key":"e_1_2_12_10_1","first-page":"561","article-title":"Aspergillus Mastoiditis in Acquired Immunodeficiency Syndrome","volume":"20","author":"Chen D.","year":"1999","journal-title":"Otology & Neurotology"},{"key":"e_1_2_12_11_1","unstructured":"A. A. J.Danishyar \u201cAcute Otitis Media \u201d2023 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK470332\/."},{"key":"e_1_2_12_12_1","unstructured":"M. S. K. C.Al Aaraj \u201cNecrotizing (Malignant) Otitis Externa \u201d2023 https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK556138\/."},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0272-6386(87)80008-2"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2006.07.004"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1007\/s15010-020-01394-8"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-006-0118-7"}],"container-title":["Clinical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccr3.70101","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,18]],"date-time":"2025-07-18T03:19:55Z","timestamp":1752808795000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccr3.70101"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1]]},"references-count":15,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2025,1]]}},"alternative-id":["10.1002\/ccr3.70101"],"URL":"https:\/\/doi.org\/10.1002\/ccr3.70101","archive":["Portico"],"relation":{},"ISSN":["2050-0904","2050-0904"],"issn-type":[{"value":"2050-0904","type":"print"},{"value":"2050-0904","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1]]},"assertion":[{"value":"2024-06-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-12-11","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-01-20","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70101"}}