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Gambaran OTOMIKOSIS
Otomycosis (Aspergillus Niger) Otomycosis-Aspergillus Speciea

• Description:Otomycosis is an infection of the external ear or external auditory canal caused by
invasion of the epidermis by fungal organisms. The fungi are most commonly airborne but may
be autoinoculated from other infected sites. Many types of fungi have been cultured from the
ear canal, but the most common pathogenic types are Aspergillus and Candida species. Itching is
the predominant symptom associated with otomycosis; however, with severe infections pain will
also occur. The diagnosis of otomycosis is based both on the,clinical appearance and fungal
cultures. The tympanic membrane and skin of the deep canal of this patient are covered with tiny
black dots which resemble carbon particles. These are the conidiophores of Aspergillus niger.
• Description:Otomycosis caused by Aspergillus species
often reveals a white, fluffy, cotton like material
(fungal hyphae). The anterior canal wall is covered
with a thin layer of white, fluffy, cotton like material.
This represents the branching hyphae of an Aspergillus
species.
Otomycosis-aspergillus fumigatus Severe otomycosis-Aspergillus Niger

• Description:Yellowish, black, or
grayish dots (conidiophores) may • Description:After the canal has been partially debrided (middle),
be found scattered over the granular inflammatory changes in the underlying epithelium are
revealed by the appearance of spontaneous bleeding. The purulent de 
involved area. The deep canal bris has now been removed (right), and the tympanic membrane over
often contains moist sheets of the short process of the malleus and the malleus handle shows a
keratin shed from the lining, granular myringitis. This was produced by the invasion of the superficial
layer of the tympanic membrane by Aspergillus niger. 
which typically resemble wet Treatment includes careful microdebridement and the application of
tissue paper. After prolonged specific antimycotic topical agents. In the case of a mixed bacterial and
treatment with topical antibiotic fungal infection, alternating treatment with topical antibiotics and
topical antimycotic agents may be required.
drugs for acute otitis externa, this
ear canal, at follow up, contained
numerous brown fruiting heads
(conidiophores), indicating
colonization of the external canal
with an Aspergillus species;
probably Aspergillus fumigatus.

Severe Aspergillus Niger Otitis Externa 1 Otomycosis-Aspergillus Niger

• Description:Th
e presence of
• Description:The deep
Aspergillus
niger is canal is grossly
revealed by edematous and there
the evidence is a drop of purulent
of brown and exudate surrounded
black by numerous needle
conidiophores like fungal hyphae.
surrounded by The organism
purulent
material
cultured was
Aspergillus niger.
Histopathology-Aspergillus Niger Histopathology-Aspergillus Niger

• Description:Under low magnification, infection by

Aspergillus niger is characterized by a row of fungal
• Description:Under higher magnification (right),
hyphae. Numerous conidiophores can be seen on the the spores which have separated from the
external surface and on the medial or deep surface a conidiophores can be seen. H&E 1250 x .
collection of chronic inflammatory cells, representing pus,
is visible. H&E 38 x

Histopathology-Aspergillus Niger Aspergillus Niger-Scanning Electron Microscope

• Description:The fruiting head, or conidiophore, of • Description:A scanning electron microscopic view of

Aspergillus niger is characterized by a central sporangium Aspergillus niger shows clusters of conidiophores lying upon a
with radiating spokes, surrounded by numerous tiny spores tangled web of hyphae. 2500 x .
on the periphery. H&E 560 x

Otomycosis
Candida Albicans
• Description:The typical discrete yeast
• Description:In contrast to Aspergillus,
otomycosis caused by Candida does not
show any visibly discernible evidence of
fungi, and consequently a diagnosis cannot
be made during otoscopic examination.
Candida Albicans-Plate culture
colonies of Candida albicans usually
appear within 3 days of culture on
Saboraud's modified agar
Candida Albicans-Histopathology
• Description:Potassium hydroxide preparations or, as in the right slide, a
routine histologic section of the exudate, will reveal the presence of
multiple branching septate pseudohyphae in clusters of grape like
budding spores. The pseudohyphae measure from 2 to 4 microns m in
diameter and the ovoid spores vary from 3 to 5 microns. H&E 200x.