Otomycosis – Symptoms, Causes, and Management

Otomycosis is a fungal infection inhabiting the outer ear. It is also known as fungal otitis externa and can affect one or both ears at a time, inhabiting the outer ear in most cases but can also infiltrate the middle ear, if left untreated. It is prevalent in tropical and subtropical regions due to intense heat and humidity.

Symptoms of otomycosis

The most common symptoms are pain, itching, and discharge, some other prominent symptoms are:

  • Pain in the ear
  • Itching and inflammation
  • Redness and swelling
  • Burning in the ear
  • Dandruff and flaky skin
  • Purulent discharge from ear with a strong odor
  • Temporary hearing loss
  • The feeling of fullness in the ear
  • Headaches
  • Colored discharge ranges from green, red, grey, yellow, or black; depending upon the type of fungus involved

Causes of otomycosis

Several types of fungi cause otomycosis, the most common of these are aspergillus and candida albicans. Both of these are common funguses that are present in our environment at all times. Candida is the normal Flora of our skin, mouth, throat, and gut. These fungi don’t cause infection in every individual, some people who have a weakened immune system or use excessive steroids are more prone to infections as compared to healthy beings.

Risk factors

Some individuals are more at risk to develop otomycosis than others. These are people with:

  • Week immune system
  • Excessive intake of antibiotics
  • Swimmers
  • Who use hearing aids, earplugs
  • Poor hygiene
  • Use of irritants like hair dyes
  • Introduction of fungi in the ear canal by cotton buds

Complications of otomycosis

A long-standing infection that is not responding to any treatment may cause some complications. Some of these rare complications are:

  • Perforation of tympanic membrane
  • Spread of infection to the middle or inner ear
  • Mastoiditis

How to prevent otomycosis?

Some measures can be taken to completely prevent otomycosis. These are:

  • Clean your accessories like earbuds and hearing aids.
  • Don’t share personal items.
  • Use a clean towel to dry the ears after a shower.
  • Maintain personal hygiene.
  • Don’t use cotton buds to clean your ear.
  • Leave a small amount of earwax in the ear, as it has antifungal properties.
  • Use a swimming cap or earplugs to prevent contamination during swimming.
  • Don’t scratch your ears as this may cause breakage in the skin, allowing the fungus to invade easily.
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Management of otomycosis

Otomycosis is one of the most common infections and can be easily managed.

Diagnosis

Your doctor will take a detailed history of your symptoms and do an examination using an otoscope to look into the ear canal. This can sometimes help visualize fungal spores. Some investigations that can be done are:

  • Sample of pus debris for culture and sensitivity
  • Complete blood picture to rule out any other ongoing infection

Treatment

Otomycosis can be managed by conventional, medical, as well as Surgical treatment.

Medical treatment

  • Antifungal ear drops containing miconazole, fluconazole, or clotrimazole if the fungus is affecting the outer side of the ear.
  • Carbamide peroxide is used to clean the ear wax.
  • An antibacterial can also be given in case of a superimposed bacterial infection.
  • Oral antifungal like itraconazole is given for aspergillus infection.
  • Nonsteroidal anti-inflammatory drugs are taken for pain relief.

Surgical treatment

In case of persistent infection, your doctor will try to remove the debris from your ear canal under aseptic measures. Some of the possible options are:

  • Dry wipes
  • Ear toilet (rinses)
  • Suctioning

Home remedies

The ear is a very sensitive organ. Any sort of contamination can cause severe infection and deteriorate into life-threatening conditions. All the home remedies should only be done if there is no perforation:

  • Rubbing alcohol and white vinegar in equal proportions can be used as ear drops, after swimming to clean them.
  • Other than this, preventive measures should be taken to avoid any such infection.

When to consult a doctor?

If the infection persists after treatment, or you get recurrent fungal infections you should consult your ENT specialist as soon as possible.

FAQ

Does otomycosis cause deafness?

Otomycosis can cause temporary deafness if the fungus has completely occluded the ear canal.

Can otomycosis spread?

No, otomycosis is not contagious.

Do fungal infections go away on their own?

Fungal infections are least likely to resolve on their own.

How long does otomycosis last?

It takes 2,3 weeks for a fungal infection to resolve completely with the aid of antifungals and supportive treatment.

Last medically reviewed on October 25, 2021.