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Title

Conventional identification of fungal species isolated from patients with otomycosis in Urmia, Iran.

Authors

Dadashzadeh, Mina; Mahdi, Diman; Esmaeilzadeh, Paridokht; Nasri, Elahe; Diba, Kambiz; Fakhim, Hamed

Abstract

Introduction: Otomycosis is one of the most frequently encountered fungal infections of external auditory canal, commonly seen in tropical and subtropical regions of the world. Various host (local, systemic) and environmental factors can predispose a person to otomycosis. Although clinical presentations along with otoscopic findings of the patients are well suggestive of fungal infections, proper identification of causative agents is mandatory in order to prevent recurrences and complications. The aims of this study were to determine the pattern of fungal agents, sex distribution, clinical presentation, predisposing factors, complications and treatment outcomes of otomycosis in Urmia, Iran. Materials and Methods: A prospective study was conducted in the Department of Mycology and Ear, Nose and Throat (ENT), Urmia, Iran, over four months period. A total of 55 consecutive patients with clinical diagnosis of otomycosis were included in the study. Demographic profile, predisposing factors, presenting complaints and clinical findings of clinically diagnosed patients were evaluated and analyzed. Samples were collected, transported and evaluated by both direct examination and culture method for bacteriological and mycological examination. Result: Male to female ratio in study participants was 42%:58%. Mycological examination yielded 84.4% fungal (n = 27) and 15.6% bacterial (n = 5) isolates in 32 samples from a total of 55 clinically diagnosed cases of otomycosis. Selfcleaning (52%), instillation of mustard oil (12%) and use of ear drops (52%) appeared to be common predisposing factors in otomycosis. The predisposing factors included frequent scratching of the external ear canal (56%), taking ototopical and / or oral antimicrobials (36%) and diabetes (8%). Significant association was observed between these practices and otomycosis. Aspergillus species (A. niger; 56.2%, A. fumigatus; 6.2%, A. tereus; 3.1% and A. flavus; 3.1%) were the predominant fungi followed by Candida species (C. Krusei; 16%) and Penicillium species (3.1%). Conclusion: The present study highlights the highest isolation of Aspergillus complex especially Aspergillus niger complex in cases of clinically diagnosed otomycosis in a rural community with higher practice of self-cleaning and using home remedies and eardrops to get relief from sensation of blocked ear and itching. However, recurrence is not uncommon and eradication of disease can be particularly difficult in patients with diabetes and a mastoid cavity.

Subjects

IRAN; DIAGNOSIS; MYCOSES; CONFERENCES & conventions

Publication

Current Medical Mycology, 2018, Vol 4, p46

ISSN

2423-3439

Publication type

Academic Journal

DOI

10.18502/cmm.4.S1.2018.180

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