A CLINICAL REVIEW- OTOMYCOSIS AND ITS PRESENTATION IN DIABETIC AND IMMUNOCOMPROMISED PATIENT IN NORTHERN INDIA

Abstract: Introduction: Otomycosis is a superficial fungal infection of the external auditory canal, often linked to bacterial infections. It is more common in tropical and subtropical regions due to their hot, humid, and dusty climates. Symptoms: include ear irritation, otalgia, auditory fullness, hearing loss, and tinnitus. Severe cases, affecting the middle ear, tympanic membrane perforation, and temporal bone, are linked to immunosuppression. Otomycosis can be caused by various fungi, with Aspergillus and Candida species being the most prevalent. Factors predisposing individuals to otomycosis: include trauma, high humidity in the external ear canal, different stages of chemical breakdown in epithelial detritus, high temperature, common illnesses like diabetic mellitus, immunodeficient individuals, and increased application of topical steroid/antibiotic formulations. Otomycosis is an inflammatory process affecting the skin and subcutaneous tissue of the external auditory canal, which can spread to the eardrum and cartilage. It can be caused by diabetes, impaired immune response, moisture accumulation, or weakened immune systems. In immunocompromised patients, severe ear pain, profuse discharge, fever, swollen lymph nodes, increased risk of complications, and cranial nerve involvement are common. The Etiology of otomycosis: can be attributed to hyperglycemia, impaired immune response, moisture accumulation, weakened immune system, fungal exposure, and antibiotic use. Complications include perforation of the tympanic membrane, hearing loss, otomastoiditis due to fungus, infections with meningitis, and massive infection of the temporal bones. Diagnosis: involves a combination of clinical examination and laboratory tests, including otoscopy, microscopy and culture, imaging, and PCR tests. Treatment: involves cleaning the ear canal, topical antifungal therapy, managing underlying conditions, and regular follow-up. Preventive strategies include proper ear hygiene, monitoring, blood glucose control, managing underlying conditions, avoiding antibiotics, using antifungal ear drops, and avoiding smoking.