Otomycosis

Otomycosis: is superficial mycotic infection of skin lining the external auditory canal. This commonly occurs in humid seasons.

Otomycosis can be classified into primary and secondary otomycosis.

Primary otomycosis: Commonly occurs during humid conditions when there is excessive moisture content in the atmosphere. This excessive moisture makes the external canal skin soggy and oedematous. This predisposes to fungal infections.

Secondary otomycosis: Occurs in immunocompromised individuals and in persons who have preexisting CSOM. Patients with CSOM usually apply broad spectrum antibiotic ear drops. This ear drops not only kills pathogens but also the natural commensals causing secondary fungal infections.

Common fungal species involved:

1. Candida albicans

2. Candida tropicalis

3. Aspergillus niger

4. Aspergillus fumigatus

Of these fungi candida infections cause whitish wet plaques within the ear canal. The plaques may also appear leathery. The aspergillus niger appear as black plaques in the external auditory canal.

Clinical features:

1. Intense itching of external canal

2. Inflammation and scaling of external canal skin

3. White / black plaques seen depending on the type of fungal infection

4. Intense pain in the ear

Treatment:

1. Dry mopping to remove plaques

2. Antifungal ear drops

3. Anti inflammatory drugs in case of acute inflammation