Otomycosis is a fungal infection of the ear, usually acquired in tropical regions. Nearly 60 varieties of fungus can cause the infection, but most often, laboratory tests reveal Aspergillus or Candida as the culprit. Careful cleaning and topical treatment will usually address the condition, but patients with chronic issues such as diabetes and skin conditions such as eczema may have more trouble treating the condition and preventing its return. Care should be taken to prevent further issues with the fungus beyond the skin, including mastoiditis and meningitis. Prevention involves drying the ears after swimming and possibly using ear drops.

Cause: Fungal sources

Otomycosis can result from fungi such as Aspergillus or Candida infecting an ear already vulnerable from bacterial infection, injury, or a lack of protective earwax. It can also result from a simple, non-invasive growth of fungus on the inner skin of the ear. The condition is much more common in warm, humid, and tropical climates. Otomycosis is more likely to grow if the ear has been exposed to water by swimming in bodies of fresh water, but it can also grow in any kind of dampness including ocean water and even indirect exposure from surfing or other activities that don’t require active submersion.

Causes: Predisposing conditions

Environmental conditions may lead to otomycosis, but certain pre-existing conditions can make it easier for fungi to grow in the ear. Weakened immune systems, ear trauma, eczema, and chronic skin conditions can allow fungi to invade the skin and make treatment more difficult. The choice of treatment should consider both the organism and any predisposing conditions.

Prevention: Drying and cleaning ears

Careful drying and cleaning of ears after swimming or any other contact with bodies of salt or fresh water can help prevent fungal infections. Ear drops containing acetic acid can also waylay infection and may contain alcohol or glycerin as drying agents. Be careful not to invade and damage the ear canal or eardrum when drying the ear or by scratching the area.

Diagnosis: Matching treatment to fungus type

Diagnosis includes understanding symptoms related to ear infections in general, such as hearing loss, itching, or a feeling of fullness in the ear. The doctor will use an otoscope to look for signs of infection within the ear canal. Then, a swab will take a sample of fungal material for lab tests, to ensure the proper medication is prescribed.

Symptoms: Feelings of infection

As the fungal infection proceeds, individuals may feel pain, itching, and inflammation or swelling of the ear. They may also feel fluid flowing from the ear, and it may be sensitive to attempts to clean it. Drying drops applied after the infection has developed may be painful.

Symptoms: Visible signs of infection

Otomycosis can result in redness around the outer ear and various fluid discharges depending on the fungus involved. Fluid colors can include white, yellow, black, gray or green. Flaky skin may also be visible around and inside the ear canal. Be careful when cleaning fluid discharges to avoid spreading infection or damaging skin in the area.

Symptoms: Hearing problems

Otomycosis can affect hearing, either by infecting the eardrum area or narrowing the ear canal. An individual may experience reduced hearing overall, a bit of an echo, or muted sound. Fungal infection of the ear can also cause ringing and a feeling of fullness. Treatment of the infection should reverse any effect on hearing, in most cases.

Treatment: Cleaning and home care

Medical treatment is the best bet for the eradication of fungal infections of the ear, but home care is important while the condition heals. It is vital to keep the ear area clean, but avoid putting anything in the ear unless directed by a doctor. Follow the doctor’s instructions about taking baths instead of showers while the ear is healing, and don’t go swimming or be exposed to water spray, either. People who have conditions such as diabetes, which may allow the infection to worsen, should continue to do their best to care for the chronic condition. Cotton with petroleum jelly can be used as a gentle earplug when bathing, and a hair dryer set on the lowest heat and held about six inches away can help speed drying when needed.

Treatment: Medications

Medical treatment of otomycosis can involve topical medications, generally antifungals or oral antifungal agents. Oral medications provide better coverage if there are concerns that the infection may spread beneath the skin, or if the patient has chronic conditions that make fungal infections harder to treat. Before treatment, the doctor will usually provide an extensive cleaning of the ear to remove as much of the surface infection as possible before treatment.

Outlook for Otomycosis

Home remedies or medical treatment may resolve individual cases of otomycosis. A return to the same swimming location may cause the infection to return, and for patients with chronic conditions such as diabetes or weakened immune system function, successful treatment may be more difficult. Should the ear infection progress to mastoiditis or meningitis, the affected individual will require further evaluation and treatment.