From the Guidelines
Fungal otitis media typically presents with symptoms such as pruritus, pain, hypoacusis, and otic discharge.
Clinical Presentations
- Pruritus
- Pain
- Hypoacusis
- Otic discharge These symptoms occur when the middle ear is involved, often as a result of a perforated tympanic membrane, which can be caused by recurrent bacterial otitis media rather than the fungal infection itself 1.
Predisposing Factors
Patients with impaired mucosal or cutaneous immunity, such as those with hypogammaglobulinemia, diabetes mellitus, chronic eczema, or HIV infection, and those who receive corticosteroids, are more susceptible to developing fungal otitis media 1.
Potential Complications
If left untreated, the fungal infection can extend into the mastoid sinus, leading to chronic fungal mastoiditis 1.
From the Research
Clinical Presentations of Fungal Otitis Media
The clinical presentations of fungal otitis media can vary, but common symptoms include:
- Ear discharge, observed in all patients 2
- Itching, reported by 86.7% of patients 2
- Pain, experienced by 46.7% of patients 2
- Decreased hearing, noted in 26.7% of patients 2
- Blocking sensation, reported by 13.3% of patients 2
Fungal Etiology
Fungal otitis media can be caused by various fungal species, including:
- Aspergillus, identified in 8 patients 2
- Mucor, seen in 3 patients 2
- Candida, found in mixed infections with Aspergillus 2
- Aspergillus spp., dominant in 65% of patients with external fungal otitis and 20% of those with fungal otitis media 3
- Candida spp., causative agents in 35% of patients with fungal external otitis and 80% of those with fungal otitis media 3
Diagnosis and Treatment
Diagnosis of fungal otitis media can be made through histopathological identification of fungal organisms 2 or culture, which is considered the gold standard 2. Treatment of fungal otitis media typically involves antifungal therapy, and prompt treatment is essential to prevent adverse outcomes 2, 4.