Invasive Aspergillus infection of middle ear in a patient treated with secukinumab, methotrexate, and corticosteroids for psoriasis and psoriatic arthritis

Abstract

Mucocutaneous mycotic infections are common complications in patients on IL-17 inhibitor therapy. We report a case of a 33-year-old male with severe psoriasis and psoriatic arthritis on secukinumab combined with methotrexate and prednisone with swelling, otorrhea, and pain of the right ear and external auditory canal. Due to progressive hypacusis, a surgical solution was chosen. Tissue samples taken during surgery revealed the presence of Aspergillus fumigatus. Aspergillosis should be suspected in prolonged otorrhea, especially in immunocompromised patients. Without intervention, the disease could be fatal.

Keywords:

• Aspergillosis
• anti-IL-17
• secukinumab
• psoriasis
• psoriatic arthritis

Disclosure statement

FR has received honoraria as a speaker and/or consultant for AbbVie, Celgene, Eli Lilly, Janssen, Leo Pharma, MSD, Novartis, Sanofi Genzyme, and UCB. LŠ, VC, JD, PK, and LP have no conflict of interest.

Additional information

Funding

This work was supported by the Cooperation Program, research area SURG and Czech Health Research Council Grant Number NU22J-05-00056.