AE # 14b OTITIS EXTERNA

An 89 year old man was referred to the ENT OPD with a 2 month
history of severe pain in the left ear associated with black mucoid
discharge. He had no recent trauma to his ear, however he uses a hearing
aid in his left ear. There is no history of diabetes, hypertension or HIV
infection.

On examination, oedematous left external auditory canal occluded

with black coloured discharge and a hearing aid is in situ. The discharge
was collected on a swab and sent to laboratory for investigations.

Based on your observations, Answer the following questions

1. what is the clinical diagnosis?

2. Record and interpret the findings of the tests displayed and identify the
organism.
3. Enumerate other infections caused by this organism.
4. What are the risk factors associated with this condition?

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1. What is the clinical diagnosis?
Otitis Externa

2. Record and interpret the findings of the tests displayed and identify
the organism.
Cultural Characteristics:
On Sabourauds Dextrose Agar slant-
− Obverse : black, powdery growth
− Reverse : white, no pigmentation

LPCB Tease Mount:

LPCB Tease Mount:

Septate hyaline hyphae with characteristic acute angle branching. Globular
vesicle, biseriate phialides (phialides in two rows) and conidia arising from
entire vesicle)

The organism is Aspergillus niger

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3. Enumerate other infections caused by this organism.
− Allergic bronchopulmonary aspergillosis
− Bronchial asthima
− Aspergilloma
− Invasive pulmonary aspergillosis
− Invasive rhinosinusitis
− Brain abscess
− Onychomycosis
− Keratitis
− Mycotoxicosis

4. What are the risk factors associated with this condition?

Objects introduced into the ear - Cotton bud, Fingertip, Match stick
Extraneous moisture - Swimming, Usage of topical ear drops
Comorbid conditions - Allergy, Diabetes mellitus, AIDS

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