II. Epidemiology
- Accounts for 10% of Acute Otitis Externa cases
- More common cause of Chronic Otitis Externa cases
III. Etiology
-
Aspergillus niger (80 to 90% of cases)
- Black exudate
- Candida albicans (second most common cause)
- Cheesy white exudate
- Actinomyces
- Trichophyton
IV. Risk Factors
- Extremely moist, hot environments
- Chronic Bacterial Otitis Externa
V. Symptoms
- Significant Ear canal pruritus more than pain
- Sensation of ear fullness
- Protracted course of Otitis Externa
VI. Signs
- Whitish-grey, yellow or black canal exudate
- Looks like a Fungal Cave
-
VII. Differential Diagnosis
VIII. Labs
-
Potassium Hydroxide (10% KOH)
- Fungal hyphae on slide
IX. Management
- See Otitis Externa for General measures (Ear toilet)
- Cleaning and debriding ear is paramount
- Otitis Externa Topical Medications
- Ear Canal Acidification
- Otic Acetic Acid 2% qid for 5 to 7 days
- Alcohol and White Vinegar 1:1 mix as drops in ear
- Topical Antifungals
- Indicated if acidification not effective
- Preparations: Intact Tympanic Membrane
- Clotrimazole 1% (Lotrimin) drops 3-4 times daily for 10-14 days or until resolved
- M-cresyl acetate (Cresylate)
- Preparation: Tympanic Membrane Perforation
- Tolnaftate 1% Solution (Tinactin)
- Systemic Antifungal
- Indicated for refractory Aspergillus infection
- Preparation: Itraconazole (Sporanox)
- Ear Canal Acidification
- Oral Analgesics for 48 hours
X. Prevention: Keep ears dry
- Instill Alcohol in both ears and let drain qhs
- Apply moisturizing cream to edge of ear canal in AM
Images: Related links to external sites (from Bing)
Related Studies
| Definition (MSH) | Fungus infection of the external ear, usually by ASPERGILLUS species |
| Definition (MSHCZE) | Mykotický, nejč. aspergilový zánět zevního zvukovodu. Při superinfekci pyogenními bakteriemi často zánět přechází až na chrupavku. Bubínek bývá zasažen vzácně. Onemocnění se projeví pruritem a vatovitým povlakem od žlutobělavé po zelenočernou barvu ve zvukovodu. Léčba spočívá v pravidelných výplaších a antimykotické lokální terapii. (cit. Velký lékařský slovník online, 2013 http://lekarske.slovniky.cz/ ) |
| Concepts | Disease or Syndrome (T047) |
| MSH | D059249 |
| SnomedCT | 275479004, 53316003 |
| Italian | Otite esterna micotica, Otomicosi |
| Japanese | 真菌性外耳炎, ｼﾝｷﾝｾｲｶﾞｲｼﾞｴﾝ |
| Czech | Mykotická otitis externa, otomykóza, ucho - mykotická infekce, otitis externa mycotica |
| Hungarian | Gombás otitis externa |
| English | Otomycosis, Otomycosis [Disease/Finding], Otitis externa fungal, Fungal otitis externa, Otomycoses, Otomycosis (disorder), Otomycosis, NOS, otomycosis |
| French | Otomycose, Otite externe fongique |
| Portuguese | Otomicose, Otite externa micótica |
| Russian | ОТОМИКОЗ, OTOMIKOZ |
| Spanish | Otomicosis, otomicosis (trastorno), otomicosis, Otitis externa fúngica |
| Polish | Grzybica ucha zewnętrznego, Grzybica ucha, Otomikoza, Grzybicze zapalenie ucha |
| German | Otomykose, Otitis externa durch Pilze |
| Norwegian | Otomykose |
| Dutch | otitis externa door schimmels |
