A fungal infection that affects the outer or middle ear, as well as the postoperative cavity that remains in the mastoid process, is called otomycosis . This disease is not accompanied by any specific clinical manifestations. It includes pain syndrome, ear discharge of varying volume, and impaired hearing function. This condition is quite difficult to treat. Despite this, in the overwhelming majority of cases, the prognosis for otomycosisfavorable. In advanced situations, this pathology can lead to the spread of an inflammatory reaction to nearby anatomical structures, for example, to the parotid gland. Other possible complications include adhesive otitis media leading to permanent hearing loss and even fungal sepsis.
Fungal infection affecting various parts of the ear is a fairly common problem in the population. According to statistics, among all otitis media, otomycosis in adults accounts for about eighteen percent. In children, this figure is already twenty-seven percent. Most often, such a pathological process is detected among people living in a tropical climatic zone. Men and women are equally often faced with otomycosis .
In the vast majority of cases, this disease is one-sided. A bilateral inflammatory reaction occurs in no more than ten percent of cases. The most severe is otomycosis , accompanied by damage to the postoperative cavity. According to statistics, about fifteen percent of such patients subsequently face relapses.
In the overwhelming majority of cases, molds belonging to the genus Aspergillus act as the causative agent of otomycosis . In addition, this infection is often caused by yeast-like fungi belonging to the genus Candida . Separately, it should be said that sometimes fungal flora can be brought into the ear from the primary candidal focus in the genital or skin area. Much less frequently, dermatophytes and actinomycetes act as pathogens .
There are a very large number of factors that contribute to the onset of this disease. First of all, these are various traumatic effects on the ear, including the ingress of foreign objects there. Existing skin pathologies accompanied by itching, for example, allergic dermatitis, can also lead to the development of an inflammatory process as a result of systematic scratching of the skin in the outer ear area. Other predisposing moments include a low level of personal hygiene, increased sweating, previous inflammatory diseases from various parts of the ear, as well as local dysbiosis. As for local dysbiosis, most often it is caused by the use of antibacterial drugs, decreased immunity, metabolic disorders, and so on.
The classification of otomycosis includes four of its main forms, distinguished on the basis of the localization of the inflammatory reaction. The first form implies the development of a fungal infection in the outer ear. According to various sources, it accounts for from twenty to fifty percent. In the second form, the middle ear is captured. She is diagnosed in about twenty percent. The third and fourth forms are lesions of the tympanic membrane and the postoperative cavity in the mastoid process, respectively.
During the course of a fungal infection, three successive stages are distinguished: precursor , acute and chronic. The precursor stage is characterized by the absence of visible clinical manifestations, however, there are complaints of discomfort in the ear area. The acute stage is accompanied by vivid inflammatory signs, and the chronic stage is accompanied by an alternation of remissions and exacerbations.
Symptoms characteristic of otomycosis
In this article, we will talk in more detail about the two most common forms of otomycosis . When the outer ear is affected, symptoms such as a feeling of congestion and itching in the external ear canal occur. The ear canal itself becomes edematous. The presence of abundant discharge from the ear is noted, and intense pain is mandatory . It is noteworthy that the pain syndrome becomes even stronger during swallowing or chewing.
On examination, another characteristic symptom is found – this is a pronounced redness of the skin of the outer ear. Often, this pathological process leads to a significant decrease in auditory function. In addition, it can be complicated by regional lymphadenitis and secondary lesions of the parotid salivary gland.
Most often, the development of a fungal inflammatory process in the middle ear is preceded by chronic inflammation already there. A sick person indicates a sudden deterioration in his condition. Symptoms such as intense ear pain , profuse discharge from the ear, worsening hearing loss and recurrent headaches are present.
Diagnosis and treatment of infection
Diagnosis of this disease cannot be based solely on concomitant clinical manifestations, since they are not specific. The leading role is played by microscopy and cultural examination of exudate from the ear. An otoscopy is mandatory. It is also recommended that a number of studies be conducted to assess auditory function.
This infection implies the appointment of special antifungal drugs. Treatment begins with the use of local antimycotics , and in the presence of relapses, systemic antifungal agents are also connected. Additionally, hyposensitizing therapy, vitamins and restorative agents are prescribed .