The fungal infection seems very difficult to shake off, but I have twice been told that regular cleaning is the secret.
Have you or your readers any recommendations for me? - C.M., Suffolk
A Infection with Aspergillus fungi, which is ubiquitous in our environment, is called 'aspergillosis', and can affect the ears as well as the eyes, nose, sinus cavities and lungs. In some cases, it can invade bone or the membranes of the central nervous system, leading to meningitis.
The fungus' tiny reproductive spores mostly enter the body via inhalation, but they can also lodge in the ear or eye. When they affect the ear, it's called 'otomycosis'. The spores may then grow in the cerumen (earwax) or debris lying in the ear canal.
The symptoms usually include itching and a discharge, sometimes noticed as a spot left on the pillow on arising.
Although everyone is bound to be exposed to this fungus at some time or other, it usually only causes disease in people who have weakened immune systems such as those who are HIV-positive or have a history of respiratory disorders. Aspergillosis can be particularly threatening in people who are already ill, such as those who have undergone cancer chemotherapy.
To dry out otomycosis, physicians prescribe antibiotic or antifungal drops or creams. As you've already discovered, not only are antibiotics ineffective against this fungus but, also, none of the currently available antifungal drugs is reliably effective, either.
The most potent alternative remedy proven to inhibit the growth of A. flavus and A. niger, the two species most commonly found in ear infections, is garlic. This plant has long been used in traditional folk medicine for its antimicrobial and other beneficial properties. In the lab (in vitro), aqueous garlic extract and concentrated garlic oil were found to have antifungal effects similar to or better than pharmaceutical preparations for aspergillosis of the ear (Lett Appl Microbiol, 1995; 20: 14-8).
In another study, garlic bulbs, green garlic and green onions were found to inhibit both A. flavus and A. niger in plants (J Food Prot, 1998; 61: 123-5).
Essential oils from, for example, tea tree, rose-scented geranium and rosemary significantly inhibited growth of A. niger and, to a lesser extent, A. flavus. In the lab, geranium's main components - geraniol and citronellol - also boosted the effects of two antifungals - amphotericin B and ketoconazole - against both fungal species (Arch Pharm Res, 2003; 26: 389-93), suggesting a possible use of a diluted version of these oils directly in the ear.
Another herb you may wish to supplement with is olive leaf. Used medicinally for centuries, this bitter compound contains elenolic acid and calcium elenolate, found to work in synergy against a wide range of microorganisms, including Escherichia coli, Klebsiella pneumoniae, Bacillus cereus, and A. flavus and A. parasiticus (Microbios, 1998; 93: 43-54). It is also known to be an immune booster.
As aspergillosis only develops where immune function is under par, you may do well to consider boosting your immunity as much as possible. You could try taking supplements known to support immune function such as goldenseal and Echinacea, not to mention those old standbys - antioxidant vitamins A, C and E.
You might also wish to try beta-1,3-D-glucan, a potent nutritional supplement extracted from baker's yeast that boosts immune function and scavenges tissue-damaging free radicals. It can help immune function by potentiating macrophages, the immune-system cells that trap and destroy foreign invaders in the body such as bacteria, virus, fungi and parasites (Dev Biol Stand, 1992; 77: 191-7).
Poor nutrition is the most common cause of a weakened immune response, so you may do well to clean up your diet and consume an unprocessed, wholefood diet, rich in immune-boosting antioxidant fruits and vegetables, and vitamin B6.
Another immune booster is wild indigo (Baptisia tinctoria) which, taken orally, can increase the number of white blood cells by 30 per cent within two or three hours (McKenna J. Natural Alternatives to Antibiotics. Dublin: Gill & MacMillan, 2003).
Finally, a word about earwashing, which was twice recommended to you. Most of the time, the ear is self-cleaning. Earwax and other debris are regularly transported along the ear canal to the outer opening, where it usually dries, flakes and falls out.
In fact, it may be that attempts to clean the ear only serve to push any wax and debris even further in, causing blockage and buildup (read all about this in next month's issue of WDDTY).
Simply keeping the ear canals dry and avoiding excessive ear cleaning can prevent repeated episodes.