From the Guidelines
Fungal acute external otitis typically presents with pruritus, pain, hypoacusis, and otic discharge 1. The symptoms are often accompanied by a visible fungal growth or a white, yellow, or black discharge in the ear canal. Key characteristics of the presentation include:
- Itching and fullness due to inflammation and swelling of the ear canal
- Discharge resulting from fungal growth and the body's attempt to fight off the infection
- Hearing loss or a feeling of blockage in the ear due to accumulation of fungal debris and discharge The most common causative fungi are Aspergillus niger and Aspergillus fumigatus 1. Patients with impaired mucosal or cutaneous immunity, such as those with hypogammaglobulinemia, diabetes mellitus, chronic eczema, or HIV infection, are more susceptible to fungal acute external otitis 1.
From the Research
Presentation of Fungal Acute External Otitis
The presentation of fungal acute external otitis, also known as otomycosis, typically includes:
- Pruritus (itching)
- Otalgia (ear pain)
- Aural fullness
- Hearing impairment
- Otorrhea (discharge from the ear)
- Tinnitus (ringing in the ear) 2, 3 The infection is usually unilateral, affecting one ear, and is more common in females than males 2. The most common fungal agents causing otomycosis are:
- Aspergillus species, with Aspergillus niger being the most common 2, 3
- Candida species, with Candida albicans being more prevalent than other yeast species 2
Epidemiology and Risk Factors
The incidence of otomycosis is higher in areas with tropical and subtropical climates, and is more prevalent among swimmers 2. The infection is also more common in summer and spring seasons, and is often associated with trauma to the external auditory canal 3. Manual workers and students have a higher frequency of otomycosis based on occupational incidence 3.
Clinical Presentation
The most common presenting complaint of otomycosis is itching, followed by other symptoms such as ear pain, discharge, and hearing impairment 2, 3. The clinical presentation of fungal acute external otitis can be similar to that of bacterial otitis externa, with symptoms such as pain, redness, and swelling of the canal 4.