clinical features
Last edited 04/2021 and last reviewed 04/2021
Otomycosis, or fungal infection of the external ear canal, is common in tropical countries, humid locations, after longterm topical antibiotic therapy, and in those with diabetes, HIV infection, or an immunocompromised state (1)
- Aspergillus
species (60%-90%) and Candida species (10%-40%) are often
cultured (1)
- often presents with pruritus, scaling, inflammation and discomfort
- itching (usually the most prominent symptom) and signs of scratching are often seen (1,2,3)
- signs of fungal infection on examining the ear canal - whitish cotton-like
strands of Candida, small black or white balls of Aspergillus ( ("wet newspaper")
- the consideration of possible fungal infection may arise only when the condition
fails to respond to antibiotics
- fungal infection may occur secondary to use of topical antibiotics
- fungal infection may occur secondary to use of topical antibiotics
- important elements in history include a possible recent holiday in warm
and holidaying in warm climate and doing water based sports such as surfing
or scuba diving
- fungal otitis externa should also be suspected if a patient fails to respond to initial topical therapy (3)
Reference:
- Rosenfeld RM, Schwartz SR, Cannon CR, et al. Clinical practice guideline: acute otitis externa.Otolaryngol Head Neck Surg2014;150(Suppl):S1-24.doi: 10.1177/0194599813517083
- NICE CKS (April 2021). Otitis externa
- Barry V et al. 10-Minute Consultation - Otitis externa. BMJ2021;372:n714http://dx.doi.org/10.1136/bmj.n714