Recently, there has been an increase in the number of fungal diseases, including lesions of the upper respiratory tract. Most often, fungal diseases of the ear occur in childhood (in 27% of cases of the total number of otitis media), but can also be diagnosed in adults. The risk group includes people who have had ear surgery and patients who wear hearing aids.
Causes of fungal diseases
Ear fungus in humans (otomycosis) develops due to the multiplication in the ear canal of certain types of harmful microorganisms: molds or fungi of the genus Candida. A common cause is saprophytic flora - mycotic organisms that are normally present on human skin in small quantities and do not show 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;
- strengthened work of sweat glands;
- metabolic disorders caused by various diseases;
- uncontrolled use of antibiotics, hormonal ointments;
- A foreign body entering the ear (details of a hearing aid in elderly patients, plant seeds, plasticine and small parts of toys in childhood, water);
- certain diseases: HIV/AIDS, diabetes, cancer, leukemia;
- infection with candida fungi in skin or genital candidiasis;
- decreased immune defense, various allergic reactions;
- poor hygiene, ear pollution;
- frequent use of headphones, wearing a hearing aid;
- combing the auricle, which often occurs with various atopic dermatitis, contact, eczema).
Weakness of the body's immune defenses
The external auditory canal is a suitable breeding ground for molds or Candida. Fungal diseases of the ears in humans do not develop if the defense mechanisms work normally. The skin in the ear canal produces a special lubricant that fungi cannot overcome. If the barrier is destroyed in some areas, for example, due to microdamages or inflammation, then the disease may begin.
Especially at risk of encountering a fungus are those who clean their ears with improvised objects or carelessly use cotton swabs. In the matter of ear hygiene, it is better not to use cotton buds at all than to do this.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 for fungal diseases and other problems, many patients prescribe themselves on their own. Therefore, otolaryngologists attribute the increase in the number of patients with mycotic lesions of the ENT organs to 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 defenses. As a result, fungi on the skin, including in the ear canal, begin to multiply actively. There is an ear fungus in humans. If the patient does not go to the doctor, but continues to be treated on his own (usually this happens), then the course of the disease is aggravated, the inflammation becomes chronic.
Localization of ear fungus
The clinical picture may be different depending on which part of the hearing aid is localized inflammation. Unpleasant symptoms of ear fungus intensify as the mycelium grows into the deeper layers of the skin. In this case, the enzymatic and toxic pathogenic influence is added to the mechanical injury. Fungal disease of the ear can be localized externally,in the middle ear, on the tympanic membrane or in the postoperative cavity.
Symptoms of an external fungus in the ear
The development of the inflammatory process is preceded by thinning of the fatty film lining the ear canal. This can happen due to microdamage or as a result of high humidity. The ear canal becomes swollen, the external secretion glands become clogged, and the patient begins to experience itching, burning, and a feeling of congestion in the ear.
In most cases, patients assume that the cause of discomfort is the formation of sulfur plugs 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 humans appears: severe swelling, hyperemia of the skin.
The acute stage is also characterized by secretions, the volume of which increases as the pathology progresses. The shade of the discharge depends on the pathogen. The discharge may be yellowish-green, grey-black, black-brown, like 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 (decrease in hearing acuity), hears noise in the ear, feels pain of considerable intensity. The pain syndrome usually increases when swallowing.
Often an additional symptomfungal disease of the ear is a local inflammation of the lymph nodes, spreading 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.
Middle ear symptoms
Fungal lesion of the middle ear usually occurs against the background of a chronic inflammatory process of the tympanic cavity. Patients complain of a general deterioration in well-being, ear pain of varying intensity, a pronounced decrease in hearing acuity, there is also a feeling of congestion and extraneous noise is heard. With fungal diseases of the ear, migraines often occur.
Symptoms of fungal myringitis
Fungal miringitis is a lesion of the eardrum that occurs against the background of an inflammatory process in the outer or middle ear. In this case, the mobility of the tympanic membrane is disturbed, which causes a pronounced hearing loss. Characterized by the presence of discharge from the ear, intense pain and other symptoms of inflammation. There are headaches, sometimes accompanied by dizziness, itching in the ear is periodically felt, the sensitivity of the auricle increases, swelling appears. During the acute phase, some patients experience an increase in body temperature. This condition is extremely rare in medical practice.
Postoperative cavity damage
Patients who have had a mastoidectomy may develop inflammation. During the procedure from the cavitymastoid process is removed pus and granulation. The operation is performed quite rarely, since the intervention in most cases can be avoided by the use of powerful antibiotics. But if drugs are ineffective, the inflammatory process becomes chronic, or severe complications arise, such as a brain abscess or meningitis, mastoidectomy becomes an inevitable procedure.
In the cavity where the mastoid cells were located, a fungal infection may begin. Painful sensations in this case are localized in the ear itself or behind the ear cavity. The amount of discharge increases significantly, but patients often ignore the need to see a doctor, as they consider such symptoms to be a variant of the norm in the postoperative period. As a result, the inflammatory process passes into a chronic stage and begins to be characterized by periodic exacerbations.
Methods of diagnosing the disease
It is not possible to make a diagnosis based only on the clinical picture. Laboratory studies are needed to select the optimal drug therapy for otomycosis. First you need to find out which type of fungus caused the inflammation, because yeast-like fungi such as Candida need to be fought differently than molds. If any pathogenic bacterium is additionally detected, additional drugs will be required. The latter happens frequently. Such a case in medical practice is called a mixed infection.
Importantcompetent differential diagnosis. Fungi of the genus Candida in appearance, for example, are very similar to weeping eczema. Therefore, it is necessary to do a crop 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 will be able to prescribe the appropriate treatment for a fungal ear disease.
Medication treatment
Treatment for fungal diseases of the ear in humans is carried out mainly with medications. The course of therapy includes taking antibiotics, antihistamines, immunostimulants and vitamins. Medicines are taken orally, and solutions and ointments are suitable for topical use. As a rule, Ketoconazole, Nystatin, Fluconazole, Natamycin are prescribed, Bifonazole, Clotrimazole, Naftifin and Miconazole are used topically. The basis of treatment can be Lamisil or Exoderil.
Treatment of fungal diseases of the ears in humans, if the causative agent is fungi of the genus Candida, is carried out using a solution of Quinozol, Levorin, Sangavirin in a 0.2% concentration. Solutions of Castellani, Kanesten based on clotrimazole, Multifungin help. It is possible to lay levorin or nystatin ointments in the ear. If the eardrum is not damaged, the solutions should not be instilled directly into the ear. Sometimes drugs are soaked in cotton wool and inserted into the external auditory canal.
Yeast mushrooms are sensitive to the use of Mycozolin, Nizoral,"Pimafutsina". While maintaining the integrity of the tympanic membrane, the use of the drug "Candibiotic" is allowed. The medicine effectively anesthetizes due to the fact that lidocaine is included in the composition. Thanks to the corticosteroid, Kadibiotic eliminates the inflammatory process quite quickly. The course of treatment rarely exceeds ten days.
Toilet of the ear is carried out with the help of various antiseptic and medicinal solutions. The accumulation of secretions is a powerful additional source of infection, so hygiene must be carried out with great care. It is possible to use vaseline 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 fails or fungal infection recurs, local therapy is supplemented with systemic drugs. Treatment with "Diflucan" is carried out 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.
Children and adults, if it is necessary to correct the immune status, are prescribed interferon inducers, for example, "Viferon" in accordance with the dosage by age. For the same purpose, the intake of lipoic or pantothenic acid, B vitamins, Wobenzym and other drugs that are prescribed forenergy metabolism optimization.
Folk remedies for the treatment of fungus
Treatment of ear fungus using traditional medicine can only be carried out under the supervision of a qualified physician. Otherwise, the disease will only worsen or severe complications may 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 relieves pain. For the treatment of ear fungus, drops from a decoction or plant juice are used. When applying, it is necessary to prevent the decoction or juice from getting into the mucous membranes and into the eyes, and after instillation, wash your hands thoroughly, because celandine is a toxic plant. In addition, this traditional medicine should not be used to treat children.
Onion juice has a strong antimicrobial effect. You need to bury the remedy in a sore ear twice or thrice a day for a maximum of four days. You can use garlic instead of onions. Chamomile is known for its pronounced anti-inflammatory properties. With a fungal infection, you can wash your ear several times a day with a decoction of dried chamomile flowers.
Prognosis of fungal diseases
With the development of severe complications (mastoiditis, chronic inflammatory process), surgicalintervention. The operation is performed when it is impossible to get rid of a fungal ear disease with conservative means. The 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 adhesive process develops, and the disease is localized in the middle ear, then the decrease in hearing acuity may be irreversible. In a complicated course, the fungus can spread to the internal organs and cause sepsis.
