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  • Also known as fungal otitis externa or "Singapore Ear"
  • A superficial fungal infection of the outer ear canal
  • Found in 9% of otitis externa cases, and as many as 30.4% of cases of symptoms of otitis[1]
  • More common in tropical/subtropical countries.
  • Common causes: Aspergillus niger and Candida albicans[1]
  • Risk factors:
    • Recent use of topical otic antibiotics
    • Topical or systemic steroids
    • Hearing aid use
    • Pregnancy
    • Local trauma

Clinical Features

  • Similar to otitis externa, but with more itching than pain
  • Characteristic appearance on exam - appears like "mold growing on spoiled food"
  • Otalgia
  • Otorrhea
  • Hearing loss
  • Pruritis
  • Tinnitus

Differential Diagnosis

Ear Diagnoses





  • Clinical diagnosis, based on history and physical examination


  1. Aural hygiene
  2. Topical antifungal
  3. Add PO antifungal treatment if poor response to topical treatment or severe disease


  • Discharge

See Also

External Links


  1. 1.0 1.1 Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: a review. Int J Pediatr Otorhinolaryngol. 2008 Apr;72(4):453-9. doi: 10.1016/j.ijporl.2007.12.005. Epub 2008 Feb 14.