From the Guidelines
Fungal acute otitis externa typically presents with pruritus, pain, hypoacusis, and otic discharge.
Clinical Presentations
- The infection usually involves the external auditory canal and may extend to the middle ear if the tympanic membrane is perforated 1.
- Aspergillus species, such as A. niger and A. fumigatus, are commonly associated with this condition 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 otitis externa 1.
- If left untreated, the infection can lead to chronic fungal mastoiditis 1.
Treatment
- Topical therapy with acetic acid or boric acid irrigations may be beneficial 1.
- Topical antifungal creams and ointments, such as nystatin, amphotericin B, and clotrimazole, may be useful, but their effectiveness is not well studied 1.
- Oral antifungal agents, such as itraconazole, voriconazole, or posaconazole, may be effective, but there is limited evidence to support their use 1.
From the Research
Clinical Presentations of Fungal Acute Otitis Externa
The clinical presentations of fungal acute otitis externa include:
- Otalgia (earache) 2, 3, 4
- Otorrhea (discharge from the ear) 2, 3, 4
- Itching 3, 4
- Fullness in the ear 4
- Hearing loss 2, 3, 4
- Tenderness with movement of the tragus or pinna 4
- Tympanic membrane perforation 3, 5
- Pruritus (itching sensation) 3
Fungal Causes
Fungal otitis externa can be caused by various fungi, including:
- Aspergillus species (e.g. Aspergillus flavus, Aspergillus tubingensis, Aspergillus niger) 6, 5
- Candida species (e.g. Candida albicans, Candida orthopsilosis, Candida parapsilosis) 6, 5
Complications
Fungal otitis externa can lead to complications such as: