From the Guidelines
Fungal 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 otitis externa 1.
- If left untreated, the infection can lead to chronic fungal mastoiditis 1.
- Topical therapy, including irrigations with acetic acid or boric acid, and topical antifungal creams and ointments, may be beneficial in managing the condition 1.
- In severe cases, systemic antifungal therapy may be necessary, particularly in immunocompromised patients 1.
From the Research
Clinical Presentations of Fungal Otitis Externa
The clinical presentations of fungal otitis externa include:
- Unilateral, rarely bilateral, earache (otalgia) 2, 3
- Accompanying hearing loss 2
- Discharge from the ear (otorrhea) 2, 3
- Itching (pruritus) 3, 4
- Tympanic membrane perforation 3, 5
Common Fungal Causes
The most common fungal causes of otitis externa are:
- Aspergillus species, including Aspergillus niger, Aspergillus flavus, and Aspergillus tubingensis 6, 4, 5
- Candida species, including Candida albicans, Candida orthopsilosis, and Candida parapsilosis 6, 5
Patient Characteristics
Fungal otitis externa can affect anyone, but it is more common among:
- Males aged 21-40 years 4
- Manual workers and students 4
- Patients with a history of trauma to the external auditory canal 4
Complications
Fungal otitis externa can lead to serious complications, such as: