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OTOMYCOSES Fungal EAC Infections © Bruce Black MD

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Page 1: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

OTOMYCOSES Fungal EAC Infections

© Bruce Black MD

Page 2: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Saprophytic fungal growth on cerumenous debris. Routine cleaning only.

© Bruce Black MD

Page 3: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Fine downy saprophytic mycelium in EAC waxy debris.

© Bruce Black MD

Page 4: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Saprophytic fungus coating deep canal debris.

© Bruce Black MD

Page 5: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

An exuberent fungal growth in the EAC, Deep canal status uncertain.

© Bruce Black MD

Page 6: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Fine fungal mycelium coating debris in the deep canal, in a chronic otitis case. Possible pathogenic infection pending.

© Bruce Black MD

Page 7: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Prolific EAC fungal mass in a case of chronic otitis media, but without evident pathological effects.

© Bruce Black MD

Page 8: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Aspergillus nigra otomycosis, displaying the typical chocolate-coloured spoors. Pruritis is common, but pain indicates ulceration or drum perforation. Treat promptly. © Bruce Black MD

Page 9: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Prolific spore formation in aspergillus nigra otomycosis. Manage with thorough suction and wet mopping, then

topical antifungals (clotrimazole drops for 2/52). © Bruce Black MD

Page 10: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Dark spores and white mycelium of A. nigra. Pruritis, blockage and deafness for some weeks. Perhaps 10% of

cases suffer drum perforation, most temporary. © Bruce Black MD

Page 11: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

A mass of aspergillus mycelium evacuated en mass by suction toilet.

© Bruce Black MD

Page 12: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Aspergillus fumigans. The discoloured “wet blotting paper” debris fills the deep canal. May be virulent, similar to a.

nigra. © Bruce Black MD

Page 13: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Aspergillus flavum otomycosis, with the typical yellow spores of this variety.

© Bruce Black MD

Page 14: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Early a. flavum infection of the left EAC.

© Bruce Black MD

Page 15: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Profuse aspergillus flavum overgrowth, right EAC. A. flavum tends to be less virulent than a. nigra. Treatment is similar.

© Bruce Black MD

Page 16: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Characteristic yellow spores and white mycelium of a. flavum. Early ulcerative foci on the anterior canal wall.

© Bruce Black MD

Page 17: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Mixed A. nigra and A. flavum otomycosis.

© Bruce Black MD

Page 18: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Mixed fungal and cerumenous debris filling the deep EAC.

© Bruce Black MD

Page 19: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Creamy debris filling the EAC. Pruritis and blockage. candida albicans otomycosis.

© Bruce Black MD

Page 20: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

Candida debris on the drum and canal wall. Clean thoroughly and treat with clotrimazole cream or lotion drops.

© Bruce Black MD

Page 21: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

A mas of creamy candida debris lodged in the anterior angle. Suction toilet and topical antifungal application.

© Bruce Black MD

Page 22: OTOMYCOSES Fungal EAC Infections - Queensland Otology · An exuberent fungal growth in the EAC, Deep canal status ... Prolific EAC fungal mass in a case of chronic otitis media, but

An unusual case of a candida albicans middle ear otomycosis, managed by drainage and systemic

antifungals. © Bruce Black MD