Fungus In The Ears - Symptoms, Causes And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2024-01-07 17:49

Fungus in the ears

Fungus in the ears is an infection that is caused by mycotic organisms, which can affect the structures of both the outer and inner ear, or the cavity of the mastoid process formed after mastoidotomy.

Fungus in the ears is a fairly common disease, more often it is diagnosed in childhood - in 27% of cases of the total number of otitis media and in 18% of cases in adults. The hotter and more humid the environmental conditions in which a person lives, the more common fungus in the ears. The fungus is diagnosed with the same frequency in men and women. A separate risk group is made up of people who have undergone ear surgery and patients who use a hearing aid.

Everywhere otolaryngologists note an increase in the number of patients with mycotic lesions of the ENT organs. They attribute this primarily to the uncontrolled use of local antibacterial drugs to get rid of otitis media. In the overwhelming majority of cases, the disease is provoked by yeast-like fungi of the genus Candida. The proportion of molds is not too high. In addition, a mixed fungal or fungal-bacterial infection is possible.

Most often, ear damage is unilateral. Bilateral infection is diagnosed only in 10% of cases.

Content:

• Symptoms of a fungus in the ears
• Causes of the appearance of fungus in the ears
• Treatment of fungus in the ears

Symptoms of a fungus in the ears

The symptoms of ear fungus will vary depending on where the inflammation is located in the ear. They tend to increase as the mycelium of the fungus grows into the deep structures of the skin. This has not only mechanical trauma, but also contributes to enzymatic and toxic pathogenic effects.

• Symptoms of external fungus in the ears. The development of the disease is preceded by the loss of the fatty film that lines the skin of the ear canal. This can happen due to microtrauma, or as a result of high humidity in the environment. The auditory canal swells, the glands located in its skin are clogged. At this time, the patient begins to experience a feeling of itching and stuffiness in the ear. Most often, people believe that the cause of such discomfort is a sulfur plug, or ear contamination, and they try to clean it on their own, while violating the integrity of the skin and favoring the penetration of mycotic infection. As a result, the patient develops acute otomycosis, in which swelling and hyperemia of the skin of the outer ear increases.

  The acute stage of the disease is characterized by the presence of secretions, the volume of which is constantly increasing. The color of the discharge may vary, depending on the characteristics of the causative agent of the fungal infection. When it is provoked by molds, the exudate will have the form of caseous masses, somewhat reminiscent of wet paper. The shade of these masses is either black-brown, gray-black, and yellowish-green. In penicillosis, the color of the discharge resembles the color of earwax.

  If the edema is severe, then the lumen of the ear canal is completely blocked. As a result, a person hears a noise in the ear and suffers from severe hearing loss, since the sound hardly reaches the eardrum.

  Painful sensations of pronounced intensity always accompany the acute stage of the external ear fungus. The pain tends to intensify while shaving and when swallowing. Together with the secretion coming out of the ear, casts can be isolated from it, which contain in their composition the mycelium of fungi and cells of the ear epidermis.

  Regional lymphadenitis is often observed, that is, inflammation of the lymph nodes that spreads to the temporomandibular joint and the parotid gland. Perhaps the involvement of the middle ear cavity in the pathological process, which often occurs in patients with diabetes mellitus or with leukemia.

• Symptoms of a fungal infection of the middle ear. This disease develops against the background of the existing chronic inflammation of the tympanic cavity. Patients complain of a deterioration in well-being, which is primarily manifested in ear pains. In addition, a pronounced hearing loss occurs, extraneous noises appear and a feeling of congestion arises. Occasionally, recurrent headaches occur.

• Symptoms of a fungal infection of the tympanic membrane. With fungal myringitis, the process spreads even deeper and captures the eardrum. Hearing falls greatly, since the mobility of the membrane is impaired. This occurs against a background of discharge from the ear, severe pain and other symptoms of inflammation.
• Symptoms of a fungal infection of the postoperative cavity. When the patient underwent a mastoidectomy, mycotic inflammation may begin in the formed cavity, where the cells of the mastoid process were previously located. The resulting pains are localized in the ear region, as well as in the ear itself. The volume of discharge increases significantly. At the same time, patients often ignore going to the doctor, since they consider such pains to be a normal phenomenon in the postoperative period.

Causes of the appearance of fungus in the ears

The most common cause of damage to various parts of the ear is the saprophytic flora. These are those mycotic organisms that normally always exist on human skin and do not show pathological activity in the absence of predisposing factors.

So, the main causes of fungus in the ears are considered to be:

• Ear foreign bodies. It can be any foreign object. Most often, this reason becomes a trigger for the development of mycotic otitis media in childhood. Children put pebbles, pieces of paper, toys, plant seeds, plasticine, cotton wool, etc. into their ears. In adulthood, foreign bodies enter the ear by accident, for example, due to injury. As for the elderly, parts of the hearing aid and batteries from it are more often found in their ears. Also, fungus in the ears can develop due to water entering the ear.
• Ear injuries. This includes injuries to the outer, middle and inner ear. Most often, the toilet of the ear canal with a cotton swab leads to microtrauma and causes disease.
• Enhanced work of the sweat glands.
• Infection with fungi of the genus Candida with genital candidiasis, or with cutaneous candidiasis.
• Combing the auricle, which most often occurs with various dermatitis (with contact, atopic dermatitis, with eczema).
• Non-observance of the rules of ear hygiene, its pollution, or alkalinization of the cover of the external auditory canal.
• The narrowness of the ear canal, the presence of exostosis.
• Local dysbiosis can lead to disruption of the normal microflora of the ear. This happens especially often after various types of otitis media.
• Taking antibacterial drugs, washing the ear with antibiotic solutions also contributes to the disruption of normal microflora.
• A decrease in the body's immune forces, impaired metabolic processes, allergic reactions are always risk factors for the development of a fungal infection, including in the ear.
• Wearing a hearing aid and frequent use of headphones can also pose a health risk.

Treatment of fungus in the ears

In order to get rid of the fungus in the ears, it is necessary to use antimycotic drugs. For this, the middle and external auditory canal is washed, as well as the postoperative cavity with various antimycotic medicinal solutions. The ear toilet is preliminarily performed - it is cleaned of exfoliated epidermis, from existing secretions, from sulfur and mycelium of the fungus.

To determine the choice of a suitable agent, it is necessary to establish the type of fungus that causes inflammation:

• Elimination of the fungus in the ears caused by yeast-like fungi of the genus Candida is carried out using a solution of Sangavirin in 0.2% concentration, a solution of Quinosol, a solution of Levorin, as well as solutions: Canesten based on clotrimazole, Castellani and Multifungin. It is also possible to put ointments in the ear - Nystatinova and Levorinova. Sometimes the solutions are instilled directly into the ear (if the eardrum is intact), and sometimes they are applied to cotton wool and inserted into the external ear canal. It is also possible to use Nizoral, Mycozolin and Pimafucin; yeast-like fungi are also sensitive to these drugs. In the absence of perforation of the tympanic membrane, it is possible to use a drug such as Candibiotic. It has a quick analgesic effect, since it contains lidocaine. Thanks to the corticosteroid,which is available in Candibiotics, inflammation of the skin of the ear is eliminated in a shorter time. As a rule, the course of treatment does not exceed 10 days.
• When the ear is affected by mold fungi, Naftifine, Terbinafine, Itraconazole, Nitrofungin are most often used. Also, the basis of treatment can be Exoderil and Lamisil.
• The ear toilet is also carried out using various medicinal and antiseptic solutions. Any accumulation of exudate or caseous masses is a powerful source of fungal infection, therefore, they must be removed with special care. It is possible to use hydrogen peroxide, vaseline oil and other oil solutions, isotonic solution. No less effective is washing the ear with a solution of Boric acid in a 3% solution and the subsequent infusion of drops of Salicylic acid in the same concentration. It is possible to lubricate the skin of the ear canal with a solution of silver nitrate in a 10% solution.
• In case of insufficient local treatment, or in case of relapse of the disease, local therapy should be supplemented by taking systemic drugs. These include: Diflucan (Fluconazole) - treatment is carried out up to 2 weeks, Orungal (Intraconazole) - the course can be up to 3 weeks, Nizoral (Ketoconazole) - the duration of the course can be up to one month. When a patient has allergic reactions, it is advisable to take antihistamines and take calcium supplements in parallel.
• The patient's diet should be fortified with vitamins, excluding all allergenic foods. The normalization of the intestinal biocenosis is important; treatment with biologically active drugs can last for three months. For this, patients are prescribed Acipol, Hilak Forte, Colibacterin, Linex, Bifikol, Lactobacterin, Bifidumbacterin, etc.
• If necessary, correction of the immune status of children and adults is prescribed interferon inducers - Viferon in accordance with the age dosage. For the same purpose, B vitamins, Lipoic and Pantothenic acid, Wobenzym are prescribed, as drugs designed to optimize energy metabolism.

In addition, the following ointments have an antimycotic effect: Amphotericin, Pevaril, Mikospor, Travogen, Chloracetophos ointment, Decamine ointment. For instillation into the ear cavity and for rinsing it, doctors also prescribe: Sodium usninat, Resorcinol, Dioxidin, Chinosol, Burov's liquid, Aniline dyes.

Surgical treatment of mycosis of the ear is possible in the case when complications such as mastoiditis and chronic cholesteatomic process with secondary otomycosis develop against its background. Also, the operation is indicated if it is impossible to get rid of the fungus in the postoperative cavity with conservative agents.

Therapy of a fungus in the ears is not an easy task, but the prognosis is most often favorable, especially when the patient has sought medical help in a timely manner. If the fungus in the ears is localized in the middle ear and the adhesion process is its cause, then the hearing loss may be irreversible. In severe cases of the disease, a fungus in the ear can lead to the spread of mycotic lesions to the internal organs and cause fungal sepsis. Therefore, therapy should be not only timely, but also qualified.

Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist

Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".