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Otomycosis
From WikEM
Contents
Background
- Also known as fungal otitis externa or "Singapore Ear"
- A superficial fungal infection of the outer ear canal
- Found in 9% of otitis externa cases, and as many as 30.4% of cases of symptoms of otitis[1]
- More common in tropical/subtropical countries.
- Common causes: Aspergillus niger and Candida albicans[1]
- Risk factors:
- Recent use of topical otic antibiotics
- Topical or systemic steroids
- Hearing aid use
- Pregnancy
- Local trauma
Clinical Features
- Similar to otitis externa, but with more itching than pain
- Characteristic appearance on exam - appears like "mold growing on spoiled food"
- Otalgia
- Otorrhea
- Hearing loss
- Pruritis
- Tinnitus
Differential Diagnosis
Ear Diagnoses
- External
- Auricular hematoma
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Mastoiditis
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
- Internal
- Acute otitis media
- Bullous myringitis
- Chronic otitis media
- Mastoiditis
- Otic barotrauma
- Inner/vestibular
Evaluation
- Clinical diagnosis, based on history and physical examination
Management
- Aural hygiene
- Topical antifungal
- Clotrimazole - most effective agent (also has some antibacterial effect)
- Ketoconazole
- Fluconazole
- Nystatin
- Add PO antifungal treatment if poor response to topical treatment or severe disease
Disposition
- Discharge
See Also
External Links
References
- ↑ 1.0 1.1 Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: a review. Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):453-9. doi: 10.1016/j.ijporl.2007.12.005. Epub 2008 Feb 14.
