H62.2 Otitis Externa in Mycoses – Causes & Treatment
H62.2 is the ICD-10 code for otitis externa in mycoses – a fungal infection of the external ear canal causing itching, discharge, and ear pain.
Things worth knowing about "H62.2"
H62.2 is the ICD-10 code for otitis externa in mycoses – a fungal infection of the external ear canal causing itching, discharge, and ear pain.
What is H62.2?
The ICD-10 code H62.2 refers to otitis externa in mycoses, which is an inflammation of the external ear canal caused by a fungal infection. This condition is also known as otomycosis and affects the ear canal between the outer ear opening and the eardrum. It can affect one or both ears and is especially common in warm, humid climates.
Causes
Otitis externa in mycoses is most commonly caused by the following fungal species:
- Aspergillus niger and other Aspergillus species (most frequent causative organism)
- Candida albicans and other Candida species
Predisposing factors include:
- Warm and humid climate or frequent swimming
- Prior or concurrent use of antibiotic or corticosteroid ear drops
- Injury or manipulation of the ear canal (e.g., from cotton swabs)
- Weakened immune system (e.g., in diabetes mellitus or HIV infection)
- Altered pH of the ear canal
- Pre-existing chronic otitis externa
Symptoms
Typical symptoms of H62.2 include:
- Intense itching in the ear canal (often the leading symptom)
- Ear discharge, often greyish, whitish, or black (depending on the causative organism)
- A feeling of blockage or fullness in the ear
- Ear pain, especially when touching or pressing the tragus
- Mild hearing loss due to blockage of the ear canal
- Occasional tinnitus (ringing in the ears)
Diagnosis
Diagnosis is typically made by an ear, nose, and throat (ENT) specialist:
- Otoscopy: Direct examination of the ear canal with an otoscope. Typical findings include fungal debris or deposits resembling wet paper or mold.
- Microscopic examination: A swab from the ear canal is examined microscopically to identify the fungal organism.
- Fungal culture (mycogram): Cultivation of the fungus for precise species identification and sensitivity testing.
- Exclusion of other ear conditions (e.g., bacterial otitis externa or cholesteatoma).
Treatment
Treatment depends on the causative fungal organism and the severity of the infection:
Local (topical) therapy
- Antifungal ear drops or ointments, e.g., containing clotrimazole, miconazole, or nystatin
- Cleaning of the ear canal by the ENT specialist (suction or irrigation) to remove fungal debris
- Acidification of the ear canal using acetic acid solutions (lowering pH inhibits fungal growth)
Systemic therapy
- In severe or extensive cases, or in immunocompromised patients, systemic antifungals (e.g., fluconazole, itraconazole) may be required.
General measures
- Keep the ear canal dry and avoid water exposure
- Discontinue or adjust antibiotic or corticosteroid ear preparations where possible
- Treatment of underlying conditions (e.g., blood sugar control in diabetes)
Prognosis
With consistent treatment, the prognosis is generally good. However, otomycosis has a tendency to recur, particularly if predisposing factors persist. Completing the full course of treatment over several weeks is essential to prevent recurrence. If left untreated, the infection may spread to the middle ear.
References
- World Health Organization (WHO): ICD-10 Classification of Mental and Behavioural Disorders – H62.2 Otitis externa in mycoses. Geneva, 2019.
- Kaur R, Mittal N, Kakkar M, Aggarwal AK, Mathur MD: Otomycosis: A Clinicomycologic Study. Ear, Nose & Throat Journal, 2000; 79(8): 606–609. PubMed PMID: 10969469.
- Ho T, Vrabec JT, Yoo D, Coker NJ: Otomycosis: Clinical Features and Treatment Implications. Otolaryngology – Head and Neck Surgery, 2006; 135(5): 787–791. PubMed PMID: 17071116.
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