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January 2, 1967


JAMA. 1967;199(1):38. doi:10.1001/jama.1967.03120010082021

Walt Whitman's thesis that we learn most from those who dispute the passage with us is still valid. Despite the recent categorization of otomycosis as a myth,1 a fungal infection of the external auditory canal caused by Aspergillus niger has been shown to be a definite clinical entity, as presented in the January issue of the Archives of Dermatology.2

Five cases were seen at a clinic in Hanover, NH, in the past year, exhibiting typical severe unilateral ear pain, sometimes of an excruciating nature, with immediate relief upon removal of grayish, fungal material from the inner third of the affected ear canal. Potassium hydroxide preparation of this material revealed the thick hyphal elements of A niger; culture on Sabouraud's agar grew the characteristic black mold in two to three days. In contrast, otitis externa is pruritic and bilateral and involves only the outer third of the external auditory