When Adarsh Nair, 19, from Bengaluru felt itching in one ear after a swim, he initially dismissed it as a minor irritant. He had become accustomed to such occasional discomfort and itching in the ear and presumed it would pass.
But as days went by, the discomfort increased and became extremely bothersome. The situation reached a point where he could not ignore it anymore. During his subsequent swimming session, he was alarmed to see a discharge in the ear.
Nair says, “Due to the relatively cold climate in the city, our swimming sessions are limited to just a few months. But whenever I went swimming, I would experience itching, pain or occasional discharge in the ear.” Until then, he had ignored the symptoms as they usually subsided after a few day. However, this time, he decided to consult an ENT (ear, nose and throat) specialist when the discomfort persisted.
The otolaryngologist confirmed that Nair had a fungal infection in the ear. Nair adds, “The doctor prescribed medication and ear drops that ultimately aided in my recovery and alleviated the symptoms.”
What is otomycosis?
A fungal ear infection mainly affects the ear canal, the tube that runs from the outer ear to the eardrum. Fungi like Aspergillus and Candida are responsible for causing this condition. While it is rare, a fungal ear infection can also affect the middle ear.
These types of ear infection are more likely to occur when the weather is warm and humid. They are more common in individuals who swim, surf or engage themselves in water activities.
How otomycosis begins
“Otomycosis is caused by fungal species such as Candida and Aspergillus,” says Dr Sanjay Bhatia, consultant ENT surgery, Fortis Hospital Mulund, Mumbai. “ The infection presents itself with a visual appearance resembling a wet newspaper, accompanied by a thick, white or grey discharge.”
Primary symptoms of fungal ear infections include itching, a sense of fullness in the ear, pain, discharge and impaired hearing. In severe cases, the infection can lead to swelling of the ear and face; The condition is known as cellulitis.
“Individuals with uncontrolled diabetes or weakened immune systems may experience complex infections involving a combination of fungal and bacterial pathogens, which can spread to the skull bones [and result in] skull base osteomyelitis,” says Dr Bhatia.
Risk factors associated with it
Dr Bhatia states that people with weakened immune systems due to medical conditions are susceptible to fungal infections. Using swabs (`earbuds’) or similar objects frequently for cleaning the ears can also increase the risk of developing fungal ear infections.
According to a 2011 research led by Dr Borlingegowda Viswanatha, professor of ENT, Victoria Hospital, Bangalore Medical College and Research Institute, otomycosis and complication due to it are commonly observed in individuals with compromised immune systems. Immuno-compromised patients face a higher risk of the infection recurring and require an extended duration of treatment.
The protective role of earwax
Earwax, also known as cerumen, provides a water-resistant lining and plays a crucial role in safeguarding the ear canal. Any factors that decrease the earwax increase the ears’ susceptibility to fungal infections.
Preventing fungal infections
Dr Girish Anand M S, consultant – ENT surgery, Aster CMI Hospital, Bengaluru, suggests that one should reduce exposure to strong breezes, dust, and refrain from putting oil drops into the ears. He also advises against using earbuds or inserting contaminated pens, pins and toothpicks into the ear canal, as these actions can disrupt natural defences and promote fungal growth.
Dr Bhatia offers the following recommendations:
- After engaging in water sports or swimming, dry your body thoroughly to prevent moisture-related fungal infections.
- Consistently maintain dryness in the ears.
- Those with diabetes should diligently manage their condition as uncontrolled diabetes can increase their susceptibility to infections.
Do not use ear swabs (`earbuds’) or other objects to remove the protective earwax.
Duration and treatment
Dr Anand says fungal ear infections typically persist for two to three weeks. The treatment involves removal of fungal debris from the ears and administration of appropriate medications to reduce the infection.
Dr Bhatia of Mumbai suggests symptomatic treatment for ear infections, including pain-relieving medicines, anti-fungal ear drops to keep the ear dry, and avoiding the use of earbuds. In severe cases, oral anti-fungal medication is prescribed for ear infections, and intravenous antibiotics are given for mixed conditions.
