Otomycosis: Difference between revisions
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==Background== | ==Background== | ||
*Also known as fungal otitis externa or "Singapore Ear" | |||
*A superficial [[fungal infection]] of the outer ear canal | |||
*Found in 9% of [[otitis externa]] cases, and as many as 30.4% of cases of symptoms of otitis<ref name="Munguia">Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: a review. Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):453-9. doi: 10.1016/j.ijporl.2007.12.005. Epub 2008 Feb 14.</ref> | |||
*More common in tropical/subtropical countries. | |||
*Common causes: ''[[Aspergillus]] niger'' and ''[[Candida albicans]]''<ref name="Munguia" /> | |||
*Risk factors: | |||
**Recent use of topical otic [[antibiotics]] | |||
**Topical or systemic [[steroids]] | |||
**Hearing aid use | |||
**[[Pregnancy]] | |||
**Local [[facial trauma|trauma]] | |||
==Clinical Features== | ==Clinical Features== | ||
*Similar to [[otitis externa]], but with more itching than pain | *Similar to [[otitis externa]], but with more itching than pain | ||
*Characteristic appearance on exam | *Characteristic appearance on exam - appears like "mold growing on spoiled food" | ||
*[[Otalgia]] | |||
*Otorrhea | |||
*[[Hearing loss]] | |||
*[[Pruritus]] | |||
*[[Tinnitus]] | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
{{Ear DDX}} | {{Ear DDX}} | ||
== | ==Evaluation== | ||
*Clinical diagnosis, based on history and physical examination | |||
==Management== | ==Management== | ||
* | #Aural hygiene | ||
* | #Topical [[antifungal]] | ||
#*[[Clotrimazole]] - most effective agent (also has some antibacterial effect) | |||
#*[[Ketoconazole]] | |||
#*[[Fluconazole]] | |||
#*[[Nystatin]] | |||
#Add PO antifungal treatment if poor response to topical treatment or severe disease | |||
==Disposition== | ==Disposition== | ||
*Discharge | |||
==See Also== | ==See Also== | ||
*[[Fungal infections]] | |||
*[[Ear diagnoses]] | |||
==External Links== | ==External Links== | ||
== | |||
==References== | |||
<references/> | <references/> | ||
[[Category:ENT]] | |||
[[Category:ID]] | |||
Latest revision as of 22:12, 30 September 2019
Background
- Also known as fungal otitis externa or "Singapore Ear"
- A superficial fungal infection of the outer ear canal
- Found in 9% of otitis externa cases, and as many as 30.4% of cases of symptoms of otitis[1]
- More common in tropical/subtropical countries.
- Common causes: Aspergillus niger and Candida albicans[1]
- Risk factors:
- Recent use of topical otic antibiotics
- Topical or systemic steroids
- Hearing aid use
- Pregnancy
- Local trauma
Clinical Features
- Similar to otitis externa, but with more itching than pain
- Characteristic appearance on exam - appears like "mold growing on spoiled food"
- Otalgia
- Otorrhea
- Hearing loss
- Pruritus
- Tinnitus
Differential Diagnosis
Ear Diagnoses
External
- Auricular hematoma
- Auricular perichondritis
- Cholesteatoma
- Contact dermatitis
- Ear foreign body
- Herpes zoster oticus (Ramsay Hunt syndrome)
- Malignant otitis externa
- Otitis externa
- Otomycosis
- Tympanic membrane rupture
Internal
- Acute otitis media
- Chronic otitis media
- Mastoiditis
Inner/vestibular
Evaluation
- Clinical diagnosis, based on history and physical examination
Management
- Aural hygiene
- Topical antifungal
- Clotrimazole - most effective agent (also has some antibacterial effect)
- Ketoconazole
- Fluconazole
- Nystatin
- Add PO antifungal treatment if poor response to topical treatment or severe disease
Disposition
- Discharge