Otomycosis in Iran: A Review

Abstract

Fungal infection of the external auditory canal (otitis externa and otomycosis) is a chronic, acute, or subacute superficial mycotic infection that rarely involves middle ear. Otomycosis (swimmer's ear) is usually unilateral infection and affects more females than males. The infection is usually symptomatic and main symptoms are pruritus, otalgia, aural fullness, hearing impairment, otorrhea, and tinnitus. Fungal species such as yeasts, molds, dermatophytes, and Malassezia species are agents for otitis externa. Among molds, Aspergillus niger was described as the most common agent in the literature. Candida albicans was more prevalent than other yeast species. Otomycosis has a worldwide distribution, but the prevalence of infection is related to the geographical location, areas with tropical and subtropical climate showing higher prevalence rates. Otomycosis is a secondary infection and is more prevalent among swimmers. As a result, a higher incidence is reported in summer season, when more people interested in swimming. Incidence of otomycosis in our review ranged from 5.7 to 81 %, with a mean value of 51.3 %. Our results showed that 78.59 % of otomycosis agents were Aspergillus, 16.76 % were Candida species, and the rest (4.65 %) were other saprophytic fungi. Among Iranian patients, incidence of infection was highest in summer, followed by autumn, winter, and spring. In Iran, otomycosis was most prevalent at the age of 20-40 years and the lowest prevalence was associated with being <10 years old. The sex ratio of otomycosis in our study was (M/F) 1:1.53.

Short Communication: Otitis externa in a tertiary care hospital in Zagazig, Egypt: Isolated pathogens and their antibiotic sensitivity patterns

“…Among the fungi, Aspergillus spp are the predominant organisms implicated in otomycosis (7). In the current study, Aspergillus spp was the most frequently isolated organism with 35.4%, which agrees with studies from Turkey (13) and Iran (14), where Aspergillus spp constituted 78.6% of otomycosis agents, followed by Candida species (6.8%) and other saprophytic fungi (4.7%). The high prevalence of fungal otitis externa may be secondary to over use of broad spectrum antibiotics and increased topical use of fluoroquinolones (13), which encourages fungi overgrowth.…”

Diagnosis and treatment of otomycosis in southern China

“…Aspergillus is the most common fungus cultured from otomycosis patients, consisting of 60%‐90% of all pathogens reported in several studies from different countries. Candida is the second most, consisting of nearly 10%‐40% . In our study, Aspergillus species were isolated in 84.3% of cases (75/89), and Candida species were found in 8.9% (8/89).…”

“…Candida is the second most, consisting of nearly 10%-40%. [7][8][9][10][11][12] However, the reported cure rates of otomycosis vary from 50% to 100%. [1][2][3][4]16 Jimenez-Garcin et al reported that 91.8% of patients treated with topical clotrimazole were cured after 2 weeks of continuous treatment, while 80% treated with topical tolnaftate were cured in the same perioid.…”

Otomycosis – A Clinico-pathological Study

“…This observation was similar to other reports. 18,19 As regards the specific specie isolated in our study, the most common was Aspergillus niger. Other researchers also grew same specie as most frequent in their studies.…”