Otomycosis or Ear Fungus

What Is Otomycosis or Ear Fungus?

Otomycosis is a fungal infection of the ear that can affect one or both ears. It is commonly seen in tropical and subtropical parts of the world, mostly during intense heat and humidity. It is also known as fungal otitis externa.

Otomycosis usually affects the outer ear canal, which connects the outer ear to the eardrum. Fungi are responsible for causing about 10 % of outer ear canal infections. In some cases, it can also affect the middle ear. It often affects people who swim frequently or have diabetes and other medical or skin conditions.

What Are the Causes of Ear Fungus?

The common causes of ear fungus are listed below -

1. Fungi -

The commonest cause for otomycosis is the development of a fungal infection, with Aspergillus and Candida being the prime causative fungi.

Aspergillus is the most common fungus which can be found everywhere. Human beings breathe in the spores of Aspergillus every day without experiencing problems. But in some cases, it can cause allergic reactions and lung infections.

Candida is responsible for causing yeast infections. It lives on the skin surface and within our bodies (in the mouth, throat, and gut).

2. Antibiotic and Steroid Use -

Recently it has been found that the cases of otomycosis are increasing. The reason behind this is the widespread use of broad-spectrum antibiotics and steroids. Most of the affected people were found to be using antibiotic ear drops, which can alter the pH levels of the ear canal and remove any good bacteria in the canal, leading to the growth of fungi.

3. Weakened Immune System -

Otomycosis is most commonly seen in people with a weakened immune system. The chances of recurrence are higher in these patients, which can cause more bodily complications. The infection can even spread from the ear canal to the temporal bone of the skull, which can be fatal if not treated.

Other than that, fungi prefer a warm and moist environment; therefore, certain activities like water sports, including frequent scuba diving or swimming, can also lead to this infection. In addition, the usage of earbuds should be limited as it removes the protective wax (cerumen) from the ear canal, providing a more favorable environment for the fungus to grow.

What Are the Symptoms of Ear Fungus?

The fungal infection can cause different types of symptoms involving one or both ears, such as -

• Itching (more common).

• Redness (typically in the outer part of the ear canal).

• Inflammation.

• Hearing problems or ringing in the ears (tinnitus).

• Pain in the ear (earache).

• A feeling of fullness in the ear.

• Severe headaches.

• Flaky skin (peeling away of the upper layer of skin).

• Fluid discharge (discharge of thick fluid from the ear, which can be yellow, green, black, white, or grey).

If Aspergillus causes the infection, grayish-black or yellow dots surrounded by cotton-like fungal spores are visible in the ear canal. A thick, creamy white discharge can be seen in the case of Candida infection.

What Are the Risk Factors Involved in This Infection?

People come in contact with multiple fungi daily, but most do not face any health issues. However, people with weak immune systems are more prone to catching an infection from the fungi.

Some of the health conditions which can increase the risk of developing fungal ear infection are as follows -

• Diabetes.

• Lymphoma (cancer of the lymphatic system - a disease-fighting network of the body).

• AIDS.

• Eczema or other skin conditions

Additionally, people undergoing radiation therapy or chemotherapy treatment are more susceptible to fungal ear infections. Some other risk factors can also increase the risk of fungal ear infection, such as -

• The amount of protective wax in the ear.

• Ear trauma caused by cotton swabs or hearing aids.

• Water sports like surfing, swimming or scuba diving.

• Frequent use of medicines such as topical antibiotics or steroids.

How Is Ear Fungus Diagnosed?

The healthcare provider diagnoses ear fungus by first taking the medical history and then examining all the symptoms of the patient. A physical examination uses an otoscope (a device used to see the inside of the ear) to check for signs of fungal infection in the ear canal and eardrum.

In case of fluid discharge from the ear, the health care provider will collect the sample and then send it to the lab to determine whether the infection is of fungal or bacterial origin. And based on that, the treatment plan is made.

What Is the Treatment for Ear Fungus?

The treatment for fungal ear infection differs from patient to patient and the severity of the infection. There are different ways this infection can be treated; some of them are -

1. Cleaning

The first step of the infection is to clean out all the debris from the ear. Healthcare providers use different tools; some use suction while others only rinse the canal. Clearing the canal will ensure better effectiveness of the medications prescribed and prevent recurring fungal infections.

2. Ear Drops

Clotrimazole is the preferred ear drop for fungal ear infections. It is very effective in preventing and treating fungal infections. Drugs such asas Econazole, Miconazole, and Amphotericin B, may also be used.

3. Topical Medications

When the infection is present on the external parts of the ear, a topical antifungal ointment can be applied to the affected area to stop the spread of the infection and reduce the symptoms. Common topical medicines for ear fungus are Clotrimazole, Fluconazole, and Ketoconazole.

4. Oral Medications

Where topical medications prove ineffective, oral medicines may be prescribed by the healthcare provider, especially in cases with Aspergillus fungal infection Itraconazole or Voriconazole is the most commonly prescribed drugs.

How to Prevent Ear Fungus?

The following steps can help prevent otomycosis or ear fungus -

• Using earplugs while swimming or engaging in other water sports.

• Drying the ears completely after taking a bath or swimming with the help of a hair dryer or towel.

• Try not to clean the ear using cotton swabs, as it can push the ear wax or debris further into the ear canal.

• Be careful not to scratch the skin surrounding the ears or inside the ear.

Conclusion:

A fungal ear infection is not serious and can be treated easily. But it is always advisable to contact a healthcare professional when experiencing symptoms. Fungal ear infections can also be prevented by maintaining hygiene and keeping the area dry and contamination-free.