Professor of ENT, Victoria Hospital, Bangalore Medical College & Research Institute, Bangalore. INDIA.
Mediterr J Hematol Infect Dis. 2011;3(1):e2011003. doi: 10.4084/MJHID.2011.003. Epub 2011 Jan 14.
Otomycosis is a fungal infection of the external ear; middle ear and open mastoid cavity.1 Meyer first described the fungal infection of the external ear canal in 1884. External ear canal has an ideal warm humid environment for the proliferation of fungus.2 Although this disease is rarely life threatening, it can presents a challenging and frustrating situation for the otologist and patients due to long term treatment and high rate of recurrence.3 Otomycosis is seen more frequently in immunocompromised patients as compared to immunocompetent persons. Recurrence rate is high in immunocompromised patients and they need longer duration treatment and complications are more frequent in immunocompromised patients.In the recent years; opportunistic fungal infections are gaining greater importance in human medicine as a result of possibly huge number of immunocompromised patients.4 In immunocompromised patients, it is important that the treatment of otomycosis be vigorous, to minimize complications such as hearing loss, tympanic membrane perforations and invasive temporal bone infection.5 Fungal cultures are essential to confirm the diagnosis.Hematological investigations play a very important role in confirming the diagnosis and immunity status of the patients. In diabetic patients with otomycosis, along with antifungal therapy, blood sugar levels should be controlled with medical therapy to prevent complications.
耳真菌病是一种外耳、中耳和开放乳突腔的真菌感染。1 Meyer 于 1884 年首次描述了外耳道的真菌感染。外耳具有理想的温暖潮湿环境,有利于真菌的增殖。2 尽管这种疾病很少危及生命,但由于长期治疗和高复发率,它会给耳科医生和患者带来具有挑战性和令人沮丧的情况。3 与免疫功能正常的人相比,免疫功能低下的患者更容易发生耳真菌病。免疫功能低下的患者复发率较高,需要更长的治疗时间,并发症也更为常见。近年来,由于大量免疫功能低下的患者,机会性真菌感染在人类医学中变得越来越重要。4 在免疫功能低下的患者中,重要的是要积极治疗耳真菌病,以尽量减少听力损失、鼓膜穿孔和侵袭性颞骨感染等并发症。5 真菌培养对于确诊是必不可少的。血液学检查对于确诊和评估患者的免疫状态非常重要。患有耳真菌病的糖尿病患者,除了抗真菌治疗外,还应通过药物治疗控制血糖水平,以预防并发症。