Otomycosis


Otomycosis is a fungal ear infection, a superficial mycotic infection of the outer ear canal. It is more common in tropical countries. The infection may be either subacute or acute and is characterized by malodorous discharge, inflammation, pruritus, scaling, and severe discomfort. Suppuration can occur due to superimposed bacterial infection commonly due to pseudomonas species and proteus species. The mycosis results in inflammation, superficial epithelial exfoliation, masses of debris containing hyphae, suppuration, and pain.

Signs and symptoms

The most common finding on ear examination is the presence of greyish white thick debris and heaviness in the ear.

Cause

Most fungal ear infections are caused by Aspergillus niger, Aspergillus fumigatus, Penicillium and Candida albicans.

Diagnosis

The fungal mass may appear white, brown or black and has been likened to a wet piece of filter paper.
Examined with an Otoscope, A.niger appears as black headed filamentous growth, A.fumigatus as pale blue or green and candida as white or creamy deposit

Treatment

Otomycosis is treated by debridement followed with topical azole antifungals, and symptomatically managed with oral antihistamines. Per a study in Iran 10cc acetic acid 2% plus 90 cc of isopropyl alcohol 70% was effective.