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External otitis: Fungal

History:
This is a 60 year old gentleman who presents with itching in his ear and decreased hearing. He has problems with cerumen and frequently has his ear irrigated. After the last irrigation, one month ago, he noticed weeping and drainage from his ear. Now the plugging and severe pruritis are his chief complaints.

Examination:
The canal is completely filled with a whitish debris. This can be wet or sometimes dry and airy. It has the appearance of mold.

^ Click on the arrow to view the video


History:
The above set of pictures are from a patient that had chronic ear drainage for many years. She has a candida infection with chronic itching.

Information: Fungus is frequently the cause of inflammatory external otitis.Fungal infection: An infection in which fungi grow in the canal causing superficial redness of the bony canal wall skin with musty smelling exudate and powdery appearing debris (fungal mycelia). Moisture and immunosuppresion increase the incidence of this otitis.
Commonly due to the Aspergillus species, a saprophytic fungus that forms a grayish (Aspergillus fumigatus) blotting paper membrane covered with black spores (Aspergillus niger). May also appear white (Candida albicans) or yellow (Aspergillus flavus). Upon suction removal the underlying tympanic membrane appears injected, edematous, and denuded of epithelium. Adequate suctioning of the ear canal is necessary for therapy and prevention. Topical antifungal drops, acidifying drops, or antifungal powders are frequently used. This condition becomes chronic if not completely treated.

Who Wants to Be a Millionaire:
Changing Conceptions of the American Dream

by Matthew Warshauer

Traditionally, Americans have sought to realise the American dream of success, fame and wealth through thrift and hard work. However, the industrialisation of the 19th and 20th centuries began to erode the dream, replacing it with a philosophy of "get rich quick". A variety of seductive but elusive strategies have evolved, and today the three leading ways to instant wealth are large-prize television game shows, big-jackpot state lotteries and compensation lawsuits. In this article, Matthew Warshauer, Professor of History at Central Connecticut State University, examines why so many Americans are persuaded to seek these easy ways to their dream.

 

American Studies Today Online

Posted 13/02/2003

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