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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.

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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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