Otomycosis (fungal ear infection, otitis fungoides)

Otomycosis (fungal ear infection, fungal otitis) is a fungal disease in which moldy yeast-like fungi develop on the skin of the auricle, the walls of the external auditory canal, the eardrum, in the tympanic cavity and the postoperative cavity of the middle ear.

ICD-10 code

• H62.2 External otitis due to mycosis.
• H74.8 Other specified diseases of middle ear and mastoid process.
• B48.8 Other specified mycoses.

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Epidemiology of fungal otitis

Among otitis of various etiologies, otomycosis accounts for 18.6%, and in childhood - 26.3%. A distinction is made between external fungal otitis (62%), fungal myringitis (1%), fungal otitis media (20%) and fungal postoperative otitis media (17%).

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Causes of fungal otitis

According to numerous studies in our climate zone, the main causative agents of otomycosis are considered to be mold fungi of the genera Aspergillus and Penicillium and yeast-like fungi of the genus Candida. At the same time, aspergillosis is diagnosed in 65% of cases, penicilliosis - in 10%, candidiasis - in 24%. In some cases, fungal infection of the ear is caused by fungi of the genera Mucor, Altemaria, Geotrichum, Kladosporium, etc. In 15% of cases, a combined infection by fungi of the genera Aspergillus and Candida is detected.

Otomycosis - Causes and pathogenesis

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Symptoms of otomycosis

Complaints and clinical manifestations of otomycosis are a consequence of the vegetation of certain fungi in the ear and are largely determined by the localization of the process.

The main complaints of otomycosis of the outer ear are: the appearance of liquid discharge (with candidiasis), the formation of crusts, plugs in the external auditory canal (with aspergillosis), itching, pain, ear congestion. Some patients in the acute stage may complain of headache, fever, increased sensitivity of the auricle, the area behind the ear and the external auditory canal. With all forms of otomycosis of the outer ear, hearing loss is not detected at all or it is insignificant due to the type of damage to the sound-conducting apparatus.

Otomycosis - Symptoms

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Classification of fungal otitis

According to the localization of the process, the following are distinguished:

• external fungal otitis;
• fungal myringitis;
• Fungal otitis media:
• fungal postoperative otitis media.

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Screening

In case of mold mycoses, otomicroscopy is necessary. Native and stained preparations of smears and/or scrapings from the skin of the external auditory canal are examined.

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Diagnosis of otomycosis

When interviewing, it is necessary to pay attention to the time of onset of the disease and the characteristics of its course. It is necessary to find out from the patient whether he has previously had otitis mycosis of another localization, the frequency, duration and nature of exacerbation.

Previous treatment (local or general), its effectiveness, and whether the condition has worsened are taken into account. It is necessary to find out whether the patient was treated with antibiotics, glucocorticoids, cytostatic drugs (duration and intensity of treatment), the specifics of working and living conditions, previous illnesses, and allergy history. Patients with otomycosis experience an increase in the frequency of exacerbations, and the absence or negative effect of standard treatment methods.

Otomycosis - Diagnostics

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Treatment of otomycosis

Treating mycotic ear infections is difficult. Treatment is not always effective enough, despite the use of various antifungal drugs. This is primarily due to the specificity of the infectious process, since opportunistic fungi of the genera Aspergillus, Candida and Penicillium cause the disease only under certain predisposing conditions. When treating patients with otomycosis, it is necessary to take into account all possible factors in each specific case in order to eliminate them. If necessary, antibiotics are discontinued, complex general strengthening treatment and vitamin therapy are carried out. Concomitant diseases such as diabetes mellitus, blood diseases, immunodeficiency states, gastrointestinal diseases and others should be identified and patients should be referred for treatment.

Otomycosis - Treatment

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