Otomycosis is an infection of the outer ear caused by fungus. This disease often makes sufferers desperate because of the long time required for treatment and also the high recurrence rate if not treated properly and correctly. This disease is mainly found in tropical countries such as Indonesia. In countries with 4 seasons, this disease is often found along with the end of summer. Therefore, this disease is also known by other names, Tropical Ear or Hot Weather Ear . This disease is also associated with the absence of cerumen which has an important function because it is antibacterial, antimycotic and also repels insects. 1
The main causes of otomycosis that are most commonly found are fungi of the Aspergillus species and Candida species. The most common cause of otomycosis found is Aspergillus niger. Some triggering factors for the onset of this disease include the absence of earwax, the habit of digging the ears with dirty objects, and continuous exposure to water, for example when swimming and shampooing. Systemic diseases such as diabetes mellitus and chronic suppurative otitis media (CSOM) also cause recurrent otomycosis. 2
The initial symptoms of otomycosis that are often encountered are discomfort in the ear, itching, discharge, pain and a feeling of fullness in the ear. On examination ear will found reddish on hole ear, there is
white mass and swelling of the ear canal. Hearing loss and ringing in the ears can also occur due to blockage of the ear canal caused by swelling of the ear canal and accumulation of secretions or white debris. 3,4
Generally, otomycosis can be cured if treated thoroughly by avoiding triggers, cleaning the fungus in the ear and administering local or systemic antifungals. Topical antifungals are better than systemic antifungals in cases of recurrent otomycosis. The use of systemic antifungals is chosen if there is no response to topical therapy and a fungal infection is suspected elsewhere. 2 Side effects of using systemic antifungals must be considered. For treatment, several visits to the doctor are usually required who will clean the fungus in the ear and provide antifungal cream. The use of topical antifungals requires special attention considering that if applied alone, there can be a buildup of cream and will cause discomfort. Antifungal ear drops are a good choice but the availability of antifungal ear drops is limited and difficult to find on the market. However, the risk of recurrence of this disease is very high, if the triggering factors that cause infection are not removed. 3,4 Therefore, it is important to know the management of otomycosis and the choice of antifungal therapy .