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ENT · External ear: otomycosis
Sample itemA farmer has itching, a feeling of fullness and wet, fluffy black and grey debris like blotting paper in the ear canal after using steroid-antibiotic drops. What is the most likely organism?
Original practice item, not a recalled exam question. Nothing here is recorded.
The answer and the reasoning
D. Aspergillus niger
Otomycosis most commonly follows prolonged topical antibiotic use and is usually caused by Aspergillus niger, with Candida second. Treatment is aural toilet and topical antifungals such as clotrimazole. Bacterial otitis externa would give pain and purulent discharge.
Option by option
A. Pseudomonas aeruginosa
Pseudomonas causes painful bacterial otitis externa with green discharge.
B. Staphylococcus aureus
Staph aureus causes furuncles and impetiginous otitis externa.
C. Streptococcus pyogenes
Streptococcus is not the typical cause of fungal-looking debris.
D. Aspergillus niger (correct)
Correct. Aspergillus niger forms black fungal debris and is the commonest cause.
Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.
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