Otomycosis – Mycological Spectrum Aetio - Pathological Factors and Management

Background Fungal otitis externa is prevalent in tropical and sub-tropical climates; however, over the past two decades, there has been a reported increase in the prevalence of otomycosis in paediatric patients from more temperate climates. This study aimed to review the children diagnosed with otomycosis at the University Hospital Limerick with reference to frequency, causative organism, predisposing factors and management. Methods A retrospective review was conducted of paediatric patients from 2001 to 2015. Patients with positive fungal ear swabs and a diagnosis of otomycosis were identified. Results Ninety-three patients were positive for candida (mean age, 5.8 years), 10 patients were positive for aspergillus (mean age, 9.1 years) and 1 patient had mixed fungal infection containing both fungi. There was a positive correlation between a diagnosis of otomycosis and prior treatment with topical fluoroquinolones (r = 0.8; p < 0.01). Conclusion The incidence of otomycosis has been increasing since 2001, which correlates with an increase in the use of topical fluoroquinolones. Previous studies identify aspergillus as the commonest causative fungi; however, this study found that candida was the commonest isolated fungi in the paediatric population.

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Otitis externa‐climatic associations and evidence‐based management strategies for Australian practice

Chidlow

Bockxmeer

2019

Australian J Rural Health

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Objectives There is a lack of consensus for the management of otitis externa. In addition to looking at seasonal trends surrounding otitis externa, this article also reviews a collection of local and international guidelines on the management of this condition. Design Retrospective case audit of clinician‐diagnosed otitis externa at the Hedland Health Campus over 18 months. Review of 2007‐2017 evidence‐based guidelines relevant to area of practice. Setting Hedland Health Campus Emergency Department in the remote Pilbara region of Western Australia. Participants Two‐hundred‐thirty‐six otitis externa cases in 193 individuals were seen by our service. Main outcome measured Number of otitis externa presentations each month. Result Nine guidelines were reviewed, which varied widely in recommendations. An overrepresentative proportion of patients identified as either Aboriginal or Torres Strait Islander. There was a strong positive correlation between the monthly rainfall and otitis externa, moderate correlation between higher monthly minimum temperatures and no correlation with maximum temperature. Given the variety of guidelines available, it was difficult to assess whether prescribing was always consistent with guidelines. Conclusion This research makes evidence‐based suggestions for Australian practitioners. Patients should be treated with oral analgesia, ear toileting and targeted topical therapy. There is no evidence for swabs, ear wicks and oral antibiotics. The authors hypothesise that re‐presentation rates might be in part attributable to freshwater pseudomonal infection.

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Otomycosis – Mycological Spectrum Aetio - Pathological Factors and Management

Cited by 3 publications

References 10 publications

Topical Antibiotic-Induced Otomycosis - a Systematic Review of Aetiology and Risk Factors

Topical Antibiotic-Induced Otomycosis - a Systematic Review of Aetiology and Risk Factors

The changing nature of paediatric otomycosis in the mid-west of Ireland

Otitis externa‐climatic associations and evidence‐based management strategies for Australian practice

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