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Otomycosis: subdermal growth in calcified mass
Tomoyuki Hoshino1, Mariko Matsumoto
1Hamamatsu ENT Surgicenter, 1696 Tenno-cho, Hamamatsu, Shizuoka 435-0052, Japan. hoshino@ent-surgicenter.com
Summary
This study reports a rare case of chronic otitis externa with fungal hyphae identified in subdermal tissue. Calcification in otomycosis, a novel finding, may indicate a protective response to antifungal treatments.
Area of Science:
- Mycology
- Dermatology
- Otolaryngology
Background:
- Chronic fungal external otitis is uncommon, with rare reports of fungal identification in subdermal tissues.
- Otomycosis, a fungal infection of the external auditory canal (EAC), can lead to severe complications.
Observation:
- An immunocompetent adult male with an 8-year history of chronic otitis externa presented with EAC pustules and tympanic membrane necrosis/perforation.
- Post-tympanoplasty, delayed wound healing and EAC swelling were observed.
Findings:
- Incision biopsy revealed fungal hyphae within small, calcified, subepidermal masses.
- Histological stains (Gomori-Grocott and PAS) confirmed the presence of fungal elements.
- Calcification is a rarely reported finding in otomycosis.
Implications:
- The presence of calcification may suggest a host defense mechanism against topical antifungal therapies.
- Successful treatment with oral itraconazole highlights the importance of systemic antifungal therapy for complex cases.
- This case expands the understanding of otomycosis pathology and potential treatment strategies.
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