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      "titulo" => "Destroyed lung with constrictive pericarditis"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">A 43-year-old patient with type II diabetes presented with left sided ear pain and itching for past one week&#46; There was no history of ear probing or use of any topical ear drops&#46; On examination cerumen along with blackish debris was seen in the left external auditory canal &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 1</a>&#41;&#46; A diagnosis of otomycosis was made and the culture of the debris grew <span class="elsevierStyleItalic">Aspergillus niger</span> species &#40;<a class="elsevierStyleCrossRef" href="#fig0010">Fig&#46; 2</a>&#41;&#46; The patient was treated with debridement of the debris and topical 1&#37; clotrimazole ear drops&#46; The patient&#39;s symptom resolved completely and is asymptomatic at 2 months of follow-up&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0010" class="elsevierStylePara elsevierViewall">Otomycosis is a fungal infection of the external auditory canal most commonly caused by <span class="elsevierStyleItalic">Candida albicans</span> and <span class="elsevierStyleItalic">A&#46; niger</span> species&#46; Predisposing factors include humid climate&#44; increased use of topical antibiotics&#47;steroid preparations&#44; immunocompromised host specially diabetes&#44; instrumentation of the ear and wearing hearing aids with occlusive ear mold&#46; The infection is usually unilateral and characterized by ear discomfort&#44; foul smelling discharge&#44; ear block&#44; pruritis which can be severe&#44; scaling and otalgia&#46; Treatment includes debridement of the fungal debris&#44; topical antifungal agents like clotrimazole and discontinuation of topical antibiotics&#46; The prognosis is good however recurrences are common&#46;</p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0005">Informed consent</span><p id="par0040" class="elsevierStylePara elsevierViewall">Informed consent was obtained from the patient&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Funding</span><p id="par0025" class="elsevierStylePara elsevierViewall">No funding was obtained and there are no financial disclosures&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Conflict of interest</span><p id="par0030" class="elsevierStylePara elsevierViewall">None&#46;</p></span></span>"
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