A superficial fungal infection of the ear; usually located in the external auditory canal, it can also be found in the middle ear or in a mastoidectomy or fenestration cavity.
Deep fungal infections involving the ear are uncommon.
Aspergillus niger, Aspergillus flavus, Aspergillus fumigatus and Candida albicans, are the organisms most commonly encountered.
Predisposing factors include moisture, e.g. swimming or showering, and the previous use of topical antibiotic ear drops, especially those containing neomycin which may kill off the normal flora of the external canal.
The symptoms of the otomycosis are itching, local irritation, persistent otorrhoea and pain.
At an early stage the pain is often more severe than the clinical appearance would warrant, suggesting to the examiner the possibility of a mycotic infection.
In the early stages, examination generally reveals a cottonwool like appearance or debris which resembles moist paper tissue.
The lumen of the canal is filled with a creamy white mucopurulent exudate. Note the fluffy white diagnostic island which consists of the fungal hyphae of Aspergillus species.