Otomycosis: Diagnosis and treatment

Area of Science:

• Otolaryngology
• Mycology
• Infectious Diseases

Background:

• Otomycosis, or fungal otitis externa, is frequently caused by Aspergillus and Candida species.
• Accurate diagnosis is crucial for effective management of fungal ear infections.

Purpose of the Study:

• To outline diagnostic methods for otomycosis.
• To review treatment strategies for fungal otitis externa, differentiating between noninvasive and invasive forms.

Main Methods:

• Diagnosis relies on patient history, otoscopic examination, and imaging.
• Microscopic examination of direct specimens with optical brighteners, mycologic culture, and histology are recommended.
• Treatment involves thorough débridement, cleansing, and topical or oral antifungal agents.

Main Results:

• Topical antifungals like clotrimazole and miconazole are safe for noninvasive otomycosis, especially with perforated eardrums.
• Oral triazoles (itraconazole, voriconazole, posaconazole) are effective for invasive fungal otitis externa, including complications like mastoiditis and meningitis.

Conclusions:

• Prompt and accurate diagnosis of otomycosis is essential.
• Treatment selection for fungal otitis externa depends on disease invasiveness and patient factors, with topical agents for noninvasive cases and oral antifungals for severe infections.