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Otomycosis – This is a disease caused by molds and yeast-like fungi. The middle and outer ear are affected. Sometimes the reproduction of the fungal form occurs after the surgery. In the general structure of otitis media, otomycosis accounts for up to 18-26% of cases of all infections. Moreover, both adults and children suffer with the same frequency. The danger of the disease lies in the fact that it occurs in the early stages of development is almost asymptomatic. It is often possible to detect an infection only after the occurrence of serious complications.
Overview
From Latin, otomycosis is translated as ear fungus. This disease is contagious. It affects the ear canal.
Such representatives of pathogenic flora can provoke an infection, such as:
Candida.
Rhizopus.
A. fumigates.
A. flavus.
A. terreus
A.
The infection can develop both in childhood and in adulthood. At risk are people who live in countries with hot climates and high levels of humidity. Also at risk are people who swim, who often use headphones, and are also forced to wear hearing aids. Otomycosis is often diagnosed in patients who have undergone mastoidectomy.
Causes of otomycosis
Otomycosis develops due to the fact that conditionally pathogenic flora begins to multiply in the ear. This leads to tissue inflammation, which negatively affects the state of the hearing organ as a whole. Sometimes, in addition to fungal microorganisms, bacteria begin to multiply in the ear. This enhances the inflammatory response.
Normally, fungi that cause otomycosis are always present on the skin of the ear. However, their growth is controlled by other microorganisms, so they do not lead to the development of the disease. In order for a person to develop ear inflammation, certain conditions are needed in which pathogenic microorganisms will feel comfortable.
Causes that can lead to the occurrence of otomycosis:
Received ear injuries, accompanied by a violation of the integrity of the skin. This can occur both with physical impact on the skin of the ear, and when foreign objects get into it. Often, small parts are thrust into the ear canal by children.
Hyperhidrosis. This disorder is characterized by excessive sweating in various parts of the body. Some people have increased sweat secretion in the parotid region. Hyperhidrosis refers to the individual characteristics of the body, but sometimes it can be triggered by a violation of metabolic processes.
Underdevelopment of the auditory canal of a congenital nature. It may be too narrow or too flexible. This makes it difficult to clean.
Taking certain medicines. Therapy with antibiotics and steroid hormones can negatively affect, since they all contribute to a decrease in the immune system.
Diseases of the body: HIV, diabetes, tuberculosis. All these pathologies negatively affect the state of human health.
Work in hazardous industries. In terms of the occurrence of otomycosis, the danger is being in conditions with a high level of humidity, in cold and dusty rooms.
Allergy to detergents, for shampoo or hair balm. Any cosmetic formulations can irritate the skin.
Furunculosis of the ear and otitis. These diseases are accompanied by inflammation and negatively affect the condition of the skin, causing an imbalance in the microflora.
Attachment of a secondary infection after suffering otitis, or after surgery (mastoidectomy). Surgical intervention is resorted to when the mastoid process becomes inflamed. During its implementation, the doctor opens the caves and cells of the mastoid process, drains them, and removes the purulent contents. If fungal flora enters the ear tissue during the operation, otomycosis will develop after some time.
Symptoms of otomycosis
Symptoms of otomycosis depend on where the inflammation was concentrated:
External otomycosis. The disease begins with the fact that the external auditory canal swells, the fatty film protecting it disappears. At this time, a person begins to experience congestion in the ear, it will itch from the inside. Most people do not go to the doctor with such symptoms, as they attribute them to the usual ear plug. They try to extract it on their own, injuring the ear canal more and more. Fungal flora easily penetrates into these microscopic lesions. It begins to multiply actively, as a result of which the inflammation intensifies. If it is very intense, the ear canal can be completely blocked, which causes hearing loss. External otomycosis is accompanied by pain, which becomes more pronounced during eating and drinking.
mycotic otitis media The cause of this inflammation is purulent otitis media. In this case, a fungal infection acts as a complication. The patient’s state of health is disturbed, the ear hurts a lot, pathological contents are released from it. Hearing deteriorates, there are noises in the ear.
Fungal miringitis. This disease is characterized by the spread of infection to the eardrum. The person complains of hearing loss. This is due to the fact that the eardrum cannot make normal oscillatory movements.
Otomycosis after surgery. The cause of inflammation is surgical intervention on the ear, for example, mastoidectomy or tympanoplasty. After they are carried out, it is necessary to use dressings for a long time. For disinfection, antibiotics and antiseptics are used, which are impregnated with bandages. This leads to the fact that the natural microflora of the ear is disturbed. The disease manifests itself with increased pain and an increase in pathological discharge.
Depending on which microorganism provoked otomycosis, the symptoms of inflammation will vary:
Ear discharge is dark in color when A. niger breeds.
The discharge from the ear turns dark yellow if the disease was caused by a fungus of the genus A. flavus.
If the disease is provoked by fungi of the genus Candida, then the discharge has a curdled consistency. The ear is covered with white crusts, which are first visible only in the ear canal, and then spread to the outer part of the ear, go beyond it, and can capture the hair growth zone. In its manifestations, the disease resembles weeping eczema.
Representatives of the genus Mucor are considered the most dangerous fungi. They belong to molds that quickly populate not only the ear, but also the nasopharynx. The patient suffers from dizziness and severe headaches. Complications of such an infection can be very severe. Body temperature rises to feverish levels, retinal thrombosis develops. In such a situation, there is a risk of loss of vision.
Types and stages of otomycosis
Otomycosis can be of the following types:
Outer. This form of otomycosis is diagnosed more often than others – in 20-50% of cases.
Mycotic.
Fungal miringitis. The defeat of the middle part of the ear is observed in 10% of cases.
Postoperative.
Depending on the characteristics of the course of the disease, several stages of development of otomycosis are distinguished:
The stage of precursors of inflammation. During this period, a person may experience congestion in the ear. There are no other signs of the disease.
Acute stage of the disease. A person has pain in the ear, the external auditory canal swells, becomes red, discharge from the ear appears. The duration of the acute stage is no more than a month. If during this period it was not possible to cope with the disease, then it passes into a subacute phase, which lasts from a month to six months.
chronic stage. Inflammation does not give bright symptoms, but it does not go away completely. The chronic stage of the disease lasts from six months or more.
Otomycosis in children
Violation of the natural balance of the microflora of the ear and a decrease in immunity leads to the fact that the child develops otomycosis. Moreover, children suffer from the disease more often than adults. The danger lies in the wrong diagnosis, which entails irrational treatment. This threatens the development of superinfection, which will be more difficult to cope with than with a conventional fungal disease.
Often, a fungal ear infection in children becomes a complication of a previous illness, such as otitis media. In older preschool and school age, mold otomycosis is more common. Babies are predominantly diagnosed with candidal otomycosis.
Fungal inflammation can be provoked by factors such as:
Passage of radiation therapy or treatment with cytostatics.
Use of topical corticosteroids.
The use of antibiotics with a wide spectrum of action.
Symptoms of otomycosis in children are varied and depend on the severity of inflammation.
Among them are:
Ear congestion.
Purulent discharge from the ear.
Itching in ear canal.
Headache.
Increased body temperature.
Maceration of the skin of the ear canal.
Earache.
Periods of remission are replaced by periods of exacerbation. This happens when the treatment was not chosen correctly, or was absent altogether, and the disease became chronic. As a rule, in children, all symptoms appear brighter than in adults.
Diagnosis of otomycosis
To diagnose otomycosis, the doctor may prescribe the following types of examinations to the patient:
Endoscopic examination.
mycological analysis.
Performing radiography.
Microbiological analysis.
With otomycosis, the ear canal will be narrowed, it will swell strongly, and liquid exudate will come out of it. In the secretions, you can see the accumulation of mycelium, but only under multiple magnification. Conducting tests allows you to determine the type of fungus, as well as select drugs to eliminate it.
Sometimes, in addition to fungal microorganisms, a microbial flora is found in the collected material. In this case, treatment involves the use of antibiotics.
In addition to general diagnostic measures, the patient may be shown such types of examinations as:
Audiometry (threshold and simple). In a simple examination, the doctor pronounces different phrases, being at a distance of 6 meters from the patient. The patient must repeat these phrases. Threshold audiometry involves the assessment of hearing using special equipment. The patient is put on headphones in which he hears sounds of different tones and frequencies. At certain sounds, a person must press a button. This allows the patient’s hearing to be assessed.
Acoustic impedancemetry. This study allows you to evaluate the mobility of the eardrum under the influence of sound waves and different pressures. For the procedure, a special insert with a probe is inserted into the ear.
Otoacoustic emission. With the help of this study, the hearing of the child is assessed. A probe is inserted into the ear canal, which is equipped with a microphone and a recording device. A person during the diagnosis will hear clicks. Based on the vibrations of the eardrum, a graph is built that allows you to detect changes in hearing, if any.
Evaluation of the patency of the auditory tube by blowing. No specialized diagnostic equipment is required.
Hearing assessment using a tuning fork. A person will hear sounds of different frequencies. This study allows you to evaluate the function of sound conduction and sound perception.
Otomycosis treatment
Based on the obtained diagnostic data, the doctor draws up a treatment regimen for otomycosis. First, you need to treat the ear canal with disinfectants, after which antifungal agents are injected into it. The doctor performs the treatment in the office, and also gives recommendations for treatment at home. The patient may be prescribed drops, ointments, drugs for oral administration. A comprehensive treatment regimen allows you to quickly cope with the infection.
To eliminate inflammation and accelerate tissue regeneration, the patient may be prescribed physiotherapy. These include: UHF EP, inductometry, ultraphoresis with Prednisolone or Hydrocortisone. These corticosteroids allow you to quickly eliminate pain, prevent fungal flora from multiplying, and relieve inflammation.
Drugs that can be prescribed to patients with otomycosis:
Antifungal agents.
Antibiotics.
Ointments for the destruction of fungal flora.
Ear drops that relieve unpleasant symptoms.
Tablets with antifungal activity.
Ear hygiene
Regardless of what treatment was prescribed to a person, first you need to thoroughly clean the ear canal from all secretions, crusts, sulfur and other contaminants. To do this, use hydrogen peroxide, Maramistin or boric acid. Remove the secretions carefully, using a cotton swab for this purpose.
The procedure for cleansing the ear should be carried out every time before introducing drugs into the ear canal.
With otomycosis, the ear is not warmed up and not washed. Both water and heat promote the reproduction of fungal flora. When a person takes a bath or shower, the ear canal should be covered with cotton. Ear hygiene is carried out according to the same rules for both children and adults. The exact dosage of the drug and the procedure for using the drugs should be checked with the otolaryngologist.
Medicines
Preparations for the treatment of otomycosis are selected after the cause of the inflammation is established and the causative agent of the disease is identified. As a rule, therapy is carried out on an outpatient basis. Hospitalization is rarely required, only in severe cases. The average duration of treatment is 1-2 weeks. The basis of therapy is antimycotics for oral administration.
Local treatment of the ear is carried out using solutions, ointments, creams and drops. If necessary, the doctor prescribes antibacterial drugs to the patient. To increase immunity, the intake of vitamin-mineral complexes may be indicated. If the patient has allergy symptoms, then he is prescribed a course of antihistamines.
When it is not possible to cope with the disease on an outpatient basis, the patient is hospitalized. The operation can be performed in the hospital.
solutions
Medicinal solutions are used to treat the ears. Their use allows you to eliminate inflammation, as well as cope with a fungal infection.
The most effective and most commonly prescribed solutions include:
Candibiotic. The drug is injected into the ear canal to relieve inflammation, destroy the fungal flora and eliminate the effects of allergies. Its use can reduce the intensity of pain. The solution is injected into the ear canal 3-4 times a day, 4-5 drops. After 3-5 days, the patient will notice an improvement. The course can last from a week to 10 days. The analogue of Candibiotic is the drug Anuran.
Nitrofungin 1%. This solution has a pronounced antifungal effect. It smells like alcohol. First, the solution is applied to cotton wool twisted into a swab, and then inserted into the ear canal. Leave cotton wool in it for 2 hours. You need to perform the procedure 3 times a day. Treatment may be prolonged. It is completed after the patient has passed all the symptoms of the disease.
Clotrimazole. This solution is used to treat a fungal infection. It acts against most representatives of the mycotic flora. The drug is applied to a cotton swab, after which it is inserted into the ear canal. Keep the tampon in the ear for 2-3 hours. The procedure is repeated 3 times a day. The course of treatment should last a month.
Ointment
There are many ointments for the treatment of otomycosis. They are used externally.
The most effective drugs include:
Pimafukort. This is an ointment of complex action. Its use allows you to destroy not only the fungal microflora, but also bacteria. Pimafukort also has a pronounced anti-inflammatory effect. The ointment is applied to cotton wool, twisted into a swab, and then inserted into the ear canal. You need to repeat these steps 2-4 times a day.
Lamisil. This ointment has a pronounced antifungal effect. It has activity against most representatives of the pathogenic flora that can cause inflammation in the ear. It is used to treat not only otomycosis, but also a fungal infection of the mucous membranes, skin and nails. It is forbidden to prescribe the drug to lactating women and women in position. The ban is due to the fact that the active substances of the drug are able to penetrate into breast milk. Lamisil is used to treat otomycosis as well as Pimafucort.
Nystatin ointment. The drug has a pronounced antifungal effect. It very quickly destroys representatives of the Candida genus. Apply the ointment directly to the affected area. Apply it in a thin layer. Perform the procedure 2 times a day. The course of treatment is a week, but can be increased by a doctor up to 10 days.
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