Recently, there has been an increase in the number of fungal diseases, including lesions of the ENT organs. Most often, fungal diseases of the ear occur in childhood (in 27% of the total number of otitis media), but can also be diagnosed in adults. The risk group includes people who have undergone surgery on the ear, and patients who use a hearing aid.
Causes of fungal diseases
A person’s ear fungus (otomycosis) develops due to the multiplication in the ear canal of certain types of harmful microorganisms: mold or fungi of the genus Candida. A common cause is saprophytic flora - mycotic organisms that are normally present in small quantities on human skin and do not exhibit pathological activity in the absence of predisposing factors.
The main risk factors for the development of otomycosis are considered to be the following:
- injuries and microdamages of the outer, middle and inner ear;
- increased work of sweat glands;
- metabolic disorders caused by various diseases;
- uncontrolled use of antibiotics, hormonal ointments;
- foreign body ingestion (hearing aid parts in elderly patients, plant seeds, plasticine and small parts of toys in childhood, water);
- some diseases: HIV / AIDS, diabetes, cancer, leukemia;
- Candida fungal infection in cutaneous or genital candidiasis;
- decreased immune defense, various allergic reactions;
- non-compliance with hygiene rules, ear contamination;
- frequent use of headphones, wearing a hearing aid;
- combing the auricle, which often occurs with various atopic, contact, eczema dermatitis).
Weakness of the body's immune defenses
The external auditory meatus is a suitable place for the propagation of mold or fungi of the genus Candida. Fungal diseases of the ears in humans do not develop if the protective mechanisms work normally. The skin in the ear canal produces a special lubricant that the fungi cannot overcome. If in some areas the barrier is destroyed, for example due to microdamage or inflammation, then the disease can begin.
Those who clean their ears with improvised objects or inaccurately use cotton buds are especially at risk of colliding with the fungus. When it comes to ear hygiene, it’s better not to use cotton buds at all than to do it wrong or too often. Protection can be destroyed due to metabolic disorders, autoimmune diseases, against the background of an allergic reaction or a general decrease in immunity.
Drug abuse
Drops in the ears with fungal diseases and other problems, many patients prescribe for themselves. Therefore, otolaryngologists associate an increase in the number of patients with mycotic lesions of ENT organs with the uncontrolled use of antibiotics or hormonal drugs for the treatment of otitis media. In most cases, there is no need to use antibacterial drugs, but patients continue to use them haphazardly and without a doctor's prescription.
This leads not only to a violation of the intestinal microflora, but also to a weakening of the body's immune defense. As a result, fungi on the skin, including in the ear canal, begin to multiply actively. There is an ear fungus in a person. If the patient does not go to the doctor, but continues to be treated on his own (this usually happens), then the course of the disease is aggravated, the inflammation becomes chronic.
Localization of the ear fungus
The clinical picture may be different depending on in which part of the auditory apparatus inflammation is localized. The unpleasant symptoms of an ear fungus increase as the mycelium grows into the deeper layers of the skin. In this case, an enzymatic and toxic pathogenic effect is added to the mechanical injury. A fungal disease of the ear can be localized externally, in the middle ear, on the eardrum or in the postoperative cavity.
Symptoms of the external fungus in the ear
The development of the inflammatory process is preceded by a thinning of the fat film lining the ear canal. This can happen due to microdamage or as a result of high humidity. The auditory meatus becomes swollen, the glands of external secretion are clogged, and the patient begins to experience itching, burning, a feeling of stuffiness in the ear.
In most cases, patients suggest that the cause of the discomfort is the formation of a sulfur plug or contamination. But attempts at self-cleansing can lead to a violation of the integrity of the skin, which is a favorable factor for the penetration of mycotic infection. As a result, a symptom of a fungal disease of the ears in a person appears: severe swelling, flushing of the skin.
The acute stage is also characterized by secretions, the volume of which increases as the pathology progresses. The hue of the discharge depends on the pathogen. Allocations can be yellowish-green, gray-black, black-brown, resembling the color of earwax or wet paper.
With severe swelling, the lumen of the ear canal can be completely closed. As a result, a person suffers from severe hearing loss (hearing loss), hears noise in the ear, feels pain of considerable intensity. Pain is usually aggravated by swallowing movements.
Often an additional symptom of a fungal disease of the ear is a local inflammation of the lymph nodes that extends to the temporomandibular joint and the parotid gland. In this case, the middle ear cavity may be involved in the pathological process, which may occur in patients with leukemia or diabetes mellitus.
Symptoms of a middle ear lesion
Fungal infection of the middle ear usually occurs against the background of the chronic inflammatory process of the tympanic cavity. Patients complain of a general deterioration in well-being, ear pains of varying intensity, a pronounced decrease in hearing acuity, a feeling of congestion also appears, and extraneous noise is heard. With fungal diseases of the ear, migraines often occur.
Symptoms of fungal myringitis
Fungal myringitis - damage to the eardrum that occurs against the background of the inflammatory process in the outer or middle ear. In this case, the mobility of the eardrum is impaired, which causes severe hearing impairment. The presence of discharge from the ear, intense pain and other symptoms of inflammation is characteristic. Headaches occur, sometimes accompanied by dizziness, itching in the ear is periodically felt, the sensitivity of the auricle increases, and swelling appears. During the acute phase, in some patients, body temperature rises. This condition is extremely rare in medical practice.
The defeat of the postoperative cavity
In patients who undergo mastidectomy, inflammation may begin. During the procedure, pus and granulation are removed from the cavity of the mastoid process. The operation is rare enough, since in most cases it is possible to avoid interventions by using powerful antibiotics. But if the drugs are ineffective, the inflammatory process goes into the chronic stage, or severe complications such as brain abscess or meningitis occur, mastoidectomy becomes an inevitable procedure.
In the cavity where the cells of the mastoid process were located, fungal infection can begin. Painful sensations in this case are localized in the ear itself or behind the ear. The volume of discharge increases significantly, but patients often ignore the need to see a doctor, since they consider such symptoms as a normal option in the postoperative period. As a result, the inflammatory process goes into the chronic stage and begins to be characterized by periodic exacerbations.
Methods for diagnosing the disease
Only the clinical picture of the diagnosis is not possible. Laboratory studies are necessary to select the optimal drug therapy for otomycosis. First you need to find out exactly what kind of fungus caused inflammation, because yeast-like fungi such as candida need to be fought differently from mold. If an additional pathogenic bacterium is additionally detected, the appointment of additional drugs will be required. The latter happens quite often. Such a case in medical practice is called mixed infection.
Competent differential diagnosis is important. Fungi of the genus Candida in appearance, for example, are very similar to weeping eczema. Therefore, it is necessary to make inoculation in order to determine the pathogen and its sensitivity to certain medications. So, it is better to entrust the diagnosis of the disease to an experienced ENT specialist, who can prescribe the appropriate treatment for a fungal ear disease.
Drug treatment
Treatment for fungal diseases of the ear in humans is carried out mainly with medications. The course of therapy includes the use of antibiotics, antihistamines, immunostimulants and vitamins. Medicines are taken orally, and solutions and ointments are suitable for local use. Typically, Ketoconazole, Nystatin, Fluconazole, Natamycin are prescribed, Bifonazole, Clotrimazole, Naftifin and Miconazole are used locally. The basis of treatment can be Lamisil or Exoderil.
Treatment of fungal diseases of the ears in humans, if the causative agent is a fungus of the genus Candida, is carried out using a solution of “Chinozol”, “Levorin”, “Sangavirin” in a 0.2% concentration. Solutions of Castellani, Kanesten based on clotrimazole, Multifungin help. Perhaps laying in the ear of levorin or nystatin ointments. If the eardrum is not damaged, solutions should not be instilled directly into the ear. Sometimes, the preparations are impregnated with cotton and inserted into the external auditory meatus.
Yeast mushrooms are sensitive to the use of "Mykozolin", "Nizoral", "Pimafucin." While maintaining the integrity of the eardrum, the use of the drug "Candibiotic" is allowed. The medicine effectively anesthetizes due to the fact that lidocaine is part of the composition. Thanks to the corticosteroid, Kadibiotic eliminates the inflammatory process rather quickly. The course of treatment rarely exceeds ten days.
Ear toilet is carried out using various antiseptic and medicinal solutions. The accumulation of secretions is a powerful additional source of infection, so hygiene should be carried out with great care. It is possible to use paraffin oil, hydrogen peroxide, boric acid (3%), isotonic solution, salicylic acid (3% solution). The skin of the ear canal is sometimes recommended to be lubricated with a solution of silver nitrate (10%).
If local treatment is ineffective or recurrence of fungal infection, local therapy is supplemented by the use of systemic drugs. Treatment with Diflucan takes up to two weeks, the course of taking Orungal can be up to three weeks, the maximum duration of treatment with Nizoral is a month. If allergic reactions occur, it is advisable to take antihistamines and calcium preparations in the form of a biological supplement.
If necessary, correction of the immune status is prescribed to children and adults, interferon inducers, for example "Viferon" in accordance with the dosage by age. For the same purpose, lipoic or pantothenic acid, B vitamins, Wobenzyme and other drugs are prescribed that are prescribed to optimize energy metabolism.
Folk remedies for the treatment of fungus
Treatment of an ear fungus with traditional medicine methods can only be carried out under the supervision of a qualified physician. Otherwise, the disease only worsen or severe complications can develop. Actively used in the treatment of fungal diseases of the ear (symptoms of damage quickly fade) celandine, onion juice, hydrogen peroxide, chamomile.
Celandine has anti-inflammatory, anesthetic and antiviral effects, kills bacteria, soothes the skin and anesthetizes. For the treatment of ear fungus, drops from a decoction or juice of a plant are used. When applying, it is necessary to prevent the broth or juice from getting on the mucous membranes and in the eyes, and after instillation, wash your hands thoroughly, because celandine is a toxic plant. In addition, this traditional medicine is unacceptable to use for the treatment of children.
Onion juice has a strong antimicrobial effect. You need to bury the product in a sore ear twice or thrice a day for a maximum of four days. Instead of onions, garlic is allowed. Camomile is known for its pronounced anti-inflammatory properties. With a fungal infection, you can wash the ear several times a day with a decoction of dried chamomile flowers.
Fungal disease prognosis
With the development of severe complications (mastoiditis, chronic inflammatory process), surgical intervention is indicated. The operation is performed if it is impossible to get rid of fungal ear disease with conservative means. Therapy of ear mycosis is a difficult task, but in most cases the prognosis is favorable, especially if the patient seeks medical help on time. If the adhesion process develops, and the disease is localized in the middle ear, then a decrease in hearing acuity may be irreversible. With a complicated course, the fungus can spread to internal organs and cause sepsis.