OTOMYCOSIS (otomycosis; Greek us, ot[os] an ear + mycosis[es]) — the disease of an ear caused by parasitic fungi.
For the first time this disease is described by Maier (E. Mayer) in 1944 O. is widespread as in the countries with tropical and subtropical climate, and in the countries with a temperate climate.
On O.'s localization distinguish fungal outside otitis, fungal average otitis and a fungal infection of ear postoperative cavities. According to V. Ya. Kunel-skaya, O. meets in 26 — 27% of cases of otitises of various etiology.
Activators of an otomycosis are generally mold fungi of the sorts Aspergillus, Penicillium, Mucor, etc., and also yeast-like fungi of the sort Candida. At the same time certain types of fungi, such as Aspergillus niger, Aspergillus fumigatus, Aspergillus flavus, Candida albicans dominate (see. Fungi parasitic ). O.'s emergence is promoted by features of an anatomic structure of outside acoustical pass, eczematic defeats and injuries of outside acoustical pass, long suppuration from an ear at chronic purulent average otitis, disbolism, the phenomena of dysbacteriosis arising at long or misapplication of antibiotics that favors to reproduction and activation of fungal flora, climatic conditions (the increased humidity). The great value in emergence, clinic and O.'s current is allocated for an allergic component.
A clinical picture
the Main complaints of sick O. — pain, an itch in an ear, noise, a congestion of an ear, a local headache on side of a sore ear. They are connected with a bruise of tissues of ear, and also enzymatic and toxic influence of fungi. In process otoskopiya (see) at fungal outside otitis the expressed infiltration and a hyperemia of walls of outside acoustical pass and a tympanic membrane and existence peculiar patol, separated in the form of a large number of caseous or holesteatomopodobny masses is noted. Color patol, separated at O. depends on coloring of a mycelium of a fungus activator of this mycosis. So, at defeat of Aspergillus niger the discharge happens gray to black points, at candidiasis — whitish, a curdled look. Are characteristic of fungal average otitis perforation of a tympanic membrane, and also the heavy growth of small granulations in a drum cavity. At fungal infections of ear postoperative cavities there is no epidermization, growth of granulations is noted, and all cavity happens filled with a large number specific separated.
O.'s current long, with slow progressing of process and periodic aggravations, to-rye are caused by a development cycle of fungi in an ear. At a number of patients the otomycosis is followed by a secondary allergic enanthesis, so-called. mikidam (see). Recurrence of a disease is possible.
the Diagnosis is made on the basis of data of the anamnesis, clinic and an otoskopiya. At a lab. to O.'s diagnosis microscopic examination patol, separated and its crops on various mediums for allocation of cultures of fungi and their identification is conducted. E.g., at defeat of Aspergillus niger, especially in an active stage of process, not only threads of a mycelium, disputes, but also characteristic bodies of a sporonosheniye — a head are visible. At candidiasis the budding blastospor and a pseudo-mycelium are observed. In clinical laboratory diagnosis of O. also serological, allergological and histologic methods of a research are used.
sick O.' Treatment is carried out with the obligatory accounting of the general condition of an organism, by a wedge, pictures, and also a type of a fungus infestant. At fungal outside otitises carry out topical antifungal treatment taking into account sensitivity of fungi to pharmaceuticals, use of liquid pharmaceuticals is reasonable: Nitrofunginum, solutions of Chinosolum, methylrosanilinum chloride, sodium salt of levorinum, etc. At fungal average otitises and fungal infections of postoperative cavities along with topical treatment purpose of nystatin, levorinum is necessary.
Forecast favorable. Treatment comes in 2 — 3 weeks.
Prevention consists in timely treatment of the diseases promoting O.'s emergence and the correct topical administration of antibiotics at treatment of diseases of an ear.
Bibliography: Kolomiychenko A. I., etc. Fungus diseases of postoperative tympanic cavities, their clinic and treatment, Zhurn, ushn., Nov. and throats, Bol., No. 1, page 43, 1968; Krasilnikov Yu. I. and With about l about d and l about in V. Yu. K to diagnosis of otomycoses, Vestn, otorinolar., No. 5, page 88, 1970; Kunelskayav. Ya. Otomycoses, M., 1968; it, Value of fungal flora at inflammatory diseases of ears, Vestn, otorinolar., No. 5, page 18, 1976; Fenwick J. D. Mycosis fungoides involving the external auditory meatus, J. Laryng., v. 89, p. 1155, 1975; McGonigle J. J. Otomycosis, Arch. Derm., v. 95, p. 45, 1967; S e n g u p-t a R. P. and. K a with k e r S. K. Otomycosis, Indian J. med. Sci., v. 32, p. 5, 1978.
V. Ya. Kunelskaya.