Otomycosis: Difference between revisions
| Line 2: | Line 2: | ||
*Also known as fungal otitis externa or "Singapore Ear" | *Also known as fungal otitis externa or "Singapore Ear" | ||
*A superficial [[fungal infection]] of the outer ear canal | *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> | *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. | *More common in tropical/subtropical countries. | ||
*Common causes: ''Aspergillus niger'' and ''Candida albicans''<ref name="Munguia" /> | *Common causes: ''[[Aspergillus niger]]'' and ''[[Candida albicans]]''<ref name="Munguia" /> | ||
*Risk factors: | *Risk factors: | ||
**Recent use of topical otic antibiotics | **Recent use of topical otic antibiotics | ||
Revision as of 15:01, 9 September 2015
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
- Pruritis
- 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
Diagnostic 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 tx if poor response to topical tx or severe disease
Disposition
- Discharge