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External otitis: Fungal

History:
This is a 60 year old gentleman who presents with itching in his ear and decreased hearing. He has problems with cerumen and frequently has his ear irrigated. After the last irrigation, one month ago, he noticed weeping and drainage from his ear. Now the plugging and severe pruritis are his chief complaints.

Examination:
The canal is completely filled with a whitish debris. This can be wet or sometimes dry and airy. It has the appearance of mold.

^ Click on the arrow to view the video


History:
The above set of pictures are from a patient that had chronic ear drainage for many years. She has a candida infection with chronic itching.

Information: Fungus is frequently the cause of inflammatory external otitis.Fungal infection: An infection in which fungi grow in the canal causing superficial redness of the bony canal wall skin with musty smelling exudate and powdery appearing debris (fungal mycelia). Moisture and immunosuppresion increase the incidence of this otitis.
Commonly due to the Aspergillus species, a saprophytic fungus that forms a grayish (Aspergillus fumigatus) blotting paper membrane covered with black spores (Aspergillus niger). May also appear white (Candida albicans) or yellow (Aspergillus flavus). Upon suction removal the underlying tympanic membrane appears injected, edematous, and denuded of epithelium. Adequate suctioning of the ear canal is necessary for therapy and prevention. Topical antifungal drops, acidifying drops, or antifungal powders are frequently used. This condition becomes chronic if not completely treated.

Locus Marker name Position (Mb) Heterozygosity Forward primer (5′→3′) Reverse primer (5′→3′) 
 1 6SL001 0.04 0.9122 CCTCACCCGATACATAGACATAGG AGAAATACCGAAATAAGGCCTCC 
 2 6SL002 0.19 0.6687 CTCTCGCTACTGTGGTACATGC CAAACTGTAAGTCATGACCATGC 
 3 DNRNGCA 0.45 0.8103 GGAGAGAGCACTAGATTCCT CTCTAGCAAAAGGAAGAGCC 
 4 RING3CA 0.47 0.7577 TGCTTATAGGGAGACTACCG CACTCTGGAAACTTCCCATC 
 5 D6S2658 0.51 0.6063 AGAGAATGGATGCTGCATGAGG GAGAGCTGGACTTTCGGGTTATACA 
 6 6BO001 0.56 0.6621 AGGGAATTCGGAACTCATTTTT GTAAACTGGGCTGAGATGTACCA 
 7 TAP1 0.59 0.6521 AGAACCAGACAGGTTTCTCCTG GGACAATATTTTGCTCCTGAGGTA 
 8 D6S2444 0.69 0.7239 GAATGCTGGGTTCTTGGCTC GGAAGGATTCTAAATAGGGGAG 
 9 G511525 0.74 0.7727 GGCCAGTCAGGAATTTTACC GACAGCTCTTCTTAACCTGC 
10В D6S1666В 0.79В 0.8812В CTGAGTTGGGCAGCATTTGВ CAACTCCAAAATGCTGGGTВ 
11В D6S2665В 0.98В 0.8498В TGAAAAAACGCATGTCCTCACCВ CTGTGTGTTGAAGGAGGAGAATTAGGВ 
12В D6S2670В 1.35В 0.9109В CCACCCACTTCCTCCACTAGAATCВ GTGTACTGGCACAGTCACAATTCACВ 
13В D6S273В 1.67В 0.7671В GCAACTTTTCTGTCAATCCAВ CCGAAAATTTGAAGTTTGGTВ 
14В D6S2671В 1.77В 0.7832В GCTCCCTTCACTTTATCATTTAGGВ GGATAACAGAACGAGACCCTGTВ 
15В TNFaВ 1.82В 0.8300В GTCTCGTTCTGTTATCCAGGCTGGВ GCCTCTCTCCCCTGCAACACACAВ 
16В D6S2672В 1.88В 0.8608В CAAACCAATCAGGGTGGCTAВ GAAGCAGTATACAGGGGCTTCAGВ 
17В MICAВ 1.97В 0.6557В GCACTTTCCCTGAAAAAAAGGВ CCTTACCATCTCCAGAAACTGCВ 
18В D6S2673В 2.00В 0.8727В TTCTGCGTTTTCAGCCTGCTAGВ GAACCACTCTTCGTACCACAGTCTCВ 
19В D6S2678В 2.14В 0.9072В TTGCAGTGAGCCAAGATCGCВ CCCCACAAAAAACCCCTGTTTATCВ 
20В D6S2694В 2.33В 0.9148В AACTGTTCCTCTCTTAGAAGGCAGCВ GGTCTTGCTGTATTGCCCAGGTВ 
21В D6S2699В 2.49В 0.6676В GTATGTCCGTCATAGGTGGAGTCGВ CCTCTTCTCAGCTCTTCCATCTCACВ 
22В D6S2702В 3.00В 0.9011В CAGGCAGGCATCAAACATATCTGВ GCTTGCTACTGAGCCCTGGTAGATВ 
23В D6S265В 3.33В 0.7606В AGGTTAATGGGTACGAACGTВ ATCGAGGTAAACAGCAGAAAВ 
24В D6S478В 3.54В 0.8364В CCTCCATAATTGTGTGAGCCВ TGCTTGGGTTAGAAGATTGGВ 
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Where thou feelest tingling life; there, exactly there, there to a hair, do I. Well, I can only give you the answer which Arago borrowed from Plutarch, cara download dengan idm di android is nineteen centuries old. Yr oedd yno lyfrau hefyd, dyna'r gwahaniaeth rhwng gwesty Cymreig a gwestai ereill.

Where thou feelest tingling life; there, exactly there, there to a hair, do I. Well, I can only give you the answer which Arago borrowed from Plutarch, cara download dengan idm di android is nineteen centuries old. Yr oedd yno lyfrau hefyd, dyna'r gwahaniaeth rhwng gwesty Cymreig a gwestai ereill.



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