Fungal Infections of the Ear in Immunocompromised Host: A Review

Abstract

Otomycosis is a fungal infection of the external ear; middle ear and open mastoid cavity.1 Meyer first described the fungal infection of the external ear canal in 1884. External ear canal has an ideal warm humid environment for the proliferation of fungus.2 Although this disease is rarely life threatening, it can presents a challenging and frustrating situation for the otologist and patients due to long term treatment and high rate of recurrence.3 Otomycosis is seen more frequently in immunocompromised patients as compared to immunocompetent persons. Recurrence rate is high in immunocompromised patients and they need longer duration treatment and complications are more frequent in immunocompromised patients.In the recent years; opportunistic fungal infections are gaining greater importance in human medicine as a result of possibly huge number of immunocompromised patients.4 In immunocompromised patients, it is important that the treatment of otomycosis be vigorous, to minimize complications such as hearing loss, tympanic membrane perforations and invasive temporal bone infection.5 Fungal cultures are essential to confirm the diagnosis.Hematological investigations play a very important role in confirming the diagnosis and immunity status of the patients. In diabetic patients with otomycosis, along with antifungal therapy, blood sugar levels should be controlled with medical therapy to prevent complications.

Otomastoiditis caused by Candida auris: Case report and literature review

“…The treatment of fungal otomastoiditis is not easy. It is necessary to combine surgical debridement with the appropriate use of systemic antifungal agents . Although C. auris in our case was susceptible to fluconazole, choosing fluconazole for empirical treatment of fungal otomastoiditis would be worrisome because of resistance.…”

“…In patients who have prolonged otorrhoea, otalgia and progressive audio‐vestibular symptoms despite adequate antibacterial therapy, the possibility of fungal infection should be considered . Aspergillus fumigatus is considered the most common causative organism of fungal otomastoiditis . So far, the otologic infections caused by Candida auris are not common and reported in 15 patients from Korea and 1 patient from Japan in 2009 .…”

A Prospective Non-Randomised Observational Case Study- The Study of Otomycosis

“…The most common offending fungus causing otomycosis in this study was Aspergillus niger (46%). 11 Uncommonly isolated fungi in this study includes Cephalosporium & Mucor spp. (2%) respectively.…”

Conductive and Mixed Hearing Losses: A Comparison between Summer and Autumn

“…Considering the seasonality as a risk factor for OM,22) incidence of conductive hearing loss is varied in different seasons because warmth affects the enteric bacteria colonization of chronic suppurative otitis media, and the frequency of isolation of enteric bacteria rises in hot climates 23). When relative humidity rises up to 80 percent, incidence of otomycosis infection goes higher, and it infects middle and external ears 24). Dampness is also the most important environmental factor connected with ear infection, since molds have serious effects on humans' immune system 25)…”