title: Otomycosis: subdermal growth in calcified mass.
abstract: Reports on clear identification of fungi in subdermal tissue in chronic fungal external otitis are rare in recent years. Our patient was an immunocompetent adult male with an 8 year history of chronic otitis externa who presented with pustules on the external auditory canal (EAC) and necrosis and perforation of the tympanic membrane. Type I tympanoplasty was performed, but wound healing was delayed and swelling of the EAC occurred. Incision biopsy and staining (Gomori-Grocott and PAS) revealed fungal hyphae within small, calcified, subepidermal masses. A 3 month course of oral itraconazole was effective in healing the lesion. Calcification, a rarely reported finding in otomycosis, may represent a protective reaction against topical use of antifungal drugs.
authors.affiliation: Hamamatsu ENT Surgicenter, 1696 Tenno-cho, Hamamatsu, Shizuoka 435-0052, Japan. hoshino@ent-surgicenter.com
authors.forename: Tomoyuki
authors.initials: T
authors.lastname: Hoshino
authors.forename: Mariko
authors.initials: M
authors.lastname: Matsumoto
mesh_terms: D001706:Biopsy; D002114:Calcinosis / Q000209:etiology / Q000473:pathology*; D002908:Chronic Disease; D004424:Ear Canal / Q000382:microbiology / Q000473:pathology / Q000601:surgery; D006801:Humans; D007121:Immunocompetence; D008297:Male; D008875:Middle Aged; D009181:Mycoses / Q000382:microbiology / Q000473:pathology*; D010032:Otitis Externa / Q000382:microbiology / Q000473:pathology*; D016896:Treatment Outcome; D014433:Tympanoplasty