Aspergillus otomycosis in external auditory canal with tympanic membrane perforation

Abstract

Most cases of otomycosis can be cured by topical treatment, but recently intractable types with progressive tympanic membrane perforation have appeared. Moreover, their characteristics are unknown. We present three cases of progressive tympanic membrane perforation secondary to otomycosis caused by aspergillus despite topical treatment. Each case presented different symptoms (otalgia, otorrhea, and itching) like normal otomycosis. There was no change in the score of β-D-glucan that would be expected with invasive fungal infection. We closed the perforation with oral antifungal medicine immediately after detection. Early invasive aspergillus otitis externa can be successfully treated with oral antifungal medicine without the need for surgical debridement, although in some cases it persists, resulting in bone exposure despite medical treatment.