Unusual Presentation of a Rare Disease: A Case Report of Fungal Necrotizing Otitis Media and Mastoiditis.

Acute necrotizing otitis media is a severe middle ear infection which causes necrosis of the tympanic cavity. A 54-year-old female was presented who suffered from diabetes mellitus and end-stage renal disease presenting with severe otalgia, initially thought to be necrotizing otitis externa. She rapidly progressed to total necrosis of the tympanic membrane. Further assessments confirmed a fungal disease caused by Candida tropicalis and Aspergillus flavus. Immediate antifungal therapy with amphotericin B and subsequent radical mastoidectomy managed to control the disease with no sign of necrosis after 3 months. Early diagnosis, aggressive systemic antifungal treatment, and surgical debridement are vital components for successful management of such cases.