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Herein a case of left ear Aspergillus otitis externa with associated persistent tympanic membrane perforation requiring tympanoplasty in an immunocompetent 28-year-old woman is described. Aspergillus otitis externa is uncommon in young immunocompetent patients lacking obvious risk factors. This clinical case highlights the importance of considering Aspergillus in the differential diagnosis of all patients presenting with otalgia and otorrhea that do not improve with antibiotic therapy to avoid complications from untreated otomycosis.