There are no official guidelines to assist in answering this question. I will search for relevant research papers instead.
From the Research
Clinical Presentations of Fungal Acute Otitis Externa (AOE)
- The clinical presentations of Fungal AOE can be diagnosed by ear endoscopy, as stated in the study 1
- Fungal AOE can be easily diagnosed by clinical symptoms and endoscopic findings, as well as fungus culture of the ear discharge 1
- The main predisposing factors associated with the disease are trauma (secondary to the constant scratching) and the use of topical antibiotics 2
- Most cases of Fungal AOE are unilateral (90.7%) 2
- The major causal agents of Fungal AOE are several species of Aspergillus, including Aspergillus flavus, Candida albicans, and Aspergillus niger 2
Treatment and Management
- A thorough debridement of the ear and the use of antifungal medication regimens, such as compound resorcinol solution, can be an effective approach for treatment of Fungal AOE 1
- Local toilet of the external auditory canal and the use of systemic antifungal agents can help prevent re-infection and the spread of disease 2