Good evening Curofians. This case is specially dedicated to "Otorhinolaryngologists" and other specialists in general. Here is an otoscopy image of a patient complaining of itching, hearing loss and otorrhea. A. What is your impression? B. Kindly describe your findings. C.What will be the management in current case? Please answer precisely and to the point. Thank you. Best regards. [Source: Internet]

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Respected sirs and madams, SUGGESTIVE KEY: Chronic suppurative otitis media with cholesteatoma showing a superimposed fungal infection. Blackish aspergillus niger fungal masses can be easily recognized. Clinically, the patient complained of otorrhea, itching, and hearing loss. Local factors that favor fungal infections include chronic otorrhea and the presence of epithelial debris. Therapy consists of cleaning the ear to remove all debris and instillation of local antifungal drops as well as lavage with 2% alcohol boric acid drops. Thank you very much. Best regards.

1 This is otomycosis ina radical mastoid cavity . 2 Looking like aspergillus with black sporangia with pus 3 Ruleout diabetes and immunocompromised states. Management is clean the ear and remove all debris local antimycotic ear drops lavage with 2% alcohol boric acid drops .

it's aspergillus Niger fungal otitis externa. the black sporangia are the diagnostic feature. good suction clearance of the mass, clotrimazole drops rule out chronic discharging ear over whose pus this fungus can grow. hot humid climates, swimming are the other risks(ear plugs for prevention)

Along with above I can see the intact shiny tympanic men,indicates there is no perforation.

dear madam what we are seeing in this pic is only a fraction of the TM. we never comment on TM findings without through suctioning. at times the discharge on the TM masks a perforation appearing as an intact TM.
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Aspergillar otomycosis

yes u r right sir.

Thats otomycosis (Aspergillus niger spores are clearly visible) Suction clearance followed by antifungal with steroid if pt not diabetic

Otomycosis Fungal sporongia may be apegillus Niger. Suction cleaning and anti fungal local application

Otomycosis . Aspergillus

aspergillus niger otomycotic colonies .topical clotrimazole abolishes them in few days