Auricular Mucormycosis: Comprehensive Literature Review.

Abstract

Auricular mucormycosis is an exceptionally rare and aggressive fungal infection primarily affecting immunocompromised individuals, particularly those with poorly controlled diabetes. This report presents the case of a 54-year-old diabetic woman with isolated auricular mucormycosis and facial nerve palsy. The patient developed right auricular edema, necrosis, and severe pain, progressing over 10 days, with no history of trauma. Initial management included broad-spectrum antibiotics and intravenous liposomal amphotericin B, followed by surgical debridement and partial auricular resection. Despite extensive soft tissue involvement, imaging revealed no bony erosion or significant compression of the facial nerve. Facial nerve function gradually improved from House-Brackmann grade IV to grade II within 38 days. The patient's condition stabilized after sequential surgical interventions and prolonged antifungal therapy, culminating in recovery by day 61. A comprehensive literature review identified 6 documented cases of auricular mucormycosis, all involving diabetic patients, with a mortality rate of 33.3%. Facial nerve paralysis, observed in 4 cases, often persisted despite infection resolution. This case underscores the importance of early diagnosis, aggressive antifungal therapy, surgical debridement, and meticulous management of underlying conditions to optimize outcomes in auricular mucormycosis, a condition with significant diagnostic and therapeutic challenges.