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Mammals (other)
Ulcerative lesion of the external ear canal causing headshaking in a horse
  1. Christina Maria Wimmer-Scherr,
  2. Laurence Evrard,
  3. Hélène Amory and
  4. Carla Cesarini
  1. Pôle Equin, Université de Liège, Faculté de Médecine Vétérinaire, Liège, Belgium
  1. Correspondence to Dr Christina Maria Wimmer-Scherr; cwscherr{at}


This case report describes the approach to an unusual case of headshaking of 1-year duration paired with unilateral ear hypersensitivity in a 11-year-old Belgian Warmblood mare. After the exclusion of other potential causes, an aural endoscopy was performed under general anaesthesia revealing an ulcerative lesion in the external right ear canal. Biopsies of this area revealed signs of skin inflammation characterised by acanthosis, hyperkeratosis and epidermal oedema leading to a diagnosis of otitis externa. Interestingly, extensive fungal flora characterised by budding yeasts was present in the stratum corneum of each biopsy. Considering the literature debating the difference between physiological fungal colonisation versus pathogenic growth, the horse received topical antifungal and steroid treatment combined with an ear cleanser solution for 12 days with subsequent resolution of most presenting complaints. A mini-review of current knowledge and terminology in human and small animal veterinary medicine concerning external otitis and otomycosis has been included.

  • clinical
  • dermatology
  • diagnostic imaging
  • Ear, Nose and Throat (ENT)
  • fungal diseases
  • horses
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  • Contributors CC, LE and CMW-S have actively participated in the work up of this patient at the Equine teaching hospital at the University of Liège. CMW-S has drafted this article and HM, CC et LE have participated in the critical revision. Final approval for publication of this version has been granted by all authors.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement No additional data are available.

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