Otomycosis is a fungal infection of the outer ear, commonly caused by Aspergillus or Candida. Symptoms include pain, redness, itching, and discharge. Diagnosis is based on clinical symptoms and examination of discharge. Treatment involves antifungal medication, and severe cases may require hospitalization. Elderly patients with diabetes mellitus are at risk of the infection spreading to the base of the skull.
Otomycosis is a fungal infection that affects the outside of the ear. A variety of fungal species can cause this infection, resulting in symptoms such as pain, redness, and decreased hearing. Diagnosis of the condition is typically based on observing the clinical symptoms and studying the discharge produced as a result of the infection. Treatment of the infection is usually done with topical or oral antifungal medications.
Several fungal species can cause otomycosis. The most common causative agent is Aspergillus, which accounts for over 80% of cases. Candida, a different type of fungus, is the second most common cause. Rarer causes may include Rhizopus, Actinomyces and Phycomycetes. Many of these fungal species are prevalent in the environment and cause an external ear infection only in patients at risk, such as those who have reduced immune systems or who have diabetes mellitus.
Symptoms of otomycosis can include pain, redness of the external ear canal, and itching. The condition is often associated with a discharge from the ear that can be thick and yellow in color. Other times this discharge may be black or white. Many patients report that the ear feels full and may have hearing problems on the affected side.
The diagnosis of otomycosis is based on understanding the patient’s clinical symptoms and knowing what other diseases the affected patient has. Patients with diabetes mellitus or a suppressed immune system have a higher risk of developing this condition than the general population. Regardless, patients are often misdiagnosed and given antibiotic ear drops because their doctors assume that the outer ear infection is caused by bacteria rather than fungi. When patients do not improve on antibiotics, fungi could be considered a cause of infection. The diagnosis can be confirmed by taking a sample of the discharge from the ear and examining it under a microscope for the presence of fungus.
Treatment of otomycosis is based on the prescription of antifungal agents. The ear is often initially cleaned after diagnosis, in hopes of removing as much of the fungus as possible. Patients are then typically given antifungal ear drops containing active ingredients such as clotrimazole or ketoconazole. Some doctors provide ear drops containing the active ingredients thimerosal or gentian violet as an alternative. More severe otomycosis infections may require oral antifungal agents.
Although otomycosis is usually easily treated, some patients, particularly elderly patients with diabetes mellitus, are at risk of the infection spreading beyond the ear and into the base of the skull. Further invasion can be deadly, particularly if the skull bones are affected. Treatment of this condition requires hospitalization and treatment with intravenous medications.
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