Otomycosis due to Filamentous Fungi
Tóm tắt
Otomycosis is common throughout the world but barely studied in Spain. Our objective was to determine the microbiological and epidemiological characteristics of this pathology in Cadiz (Spain) between 2005 and 2010. Samples from patients with suspicion of otomycosis underwent a direct microscopic examination and culture on different media for fungi and bacteria. Mycological cultures were incubated at 30°C for at least seven days. Identification of fungi was based on colonial morphology and microscopic examination of fungal structure. From a total of 2,633 samples, microbial growth was present in 1,375 (52.2%) and fungal isolation in 390 (28.4%). We identified 228 yeasts and 184 filamentous fungi (13.4% of positive cultures and 47.2% of otomycosis), associated with yeasts in 22 cases (5.6%). The most frequent species were Aspergillus flavus (42.4%), A. niger (35.9%), A. fumigatus (12.5%), A. candidus (7.1%), A. terreus (1.6%), and Paecilomyces variotii (0.5%). Infection was predominant in men (54.9%) and patients beyond 55 years old (46.8%). The most common clinical symptoms were itching (98.9%), otalgia (59.3%), and hypoacusis (56.0%). Fall season reported the lowest number of cases (20.1%). Incidence of otomycosis and fungi producing otomycosis vary within the distinct geographical areas. In Cadiz, this infection is endemic due to warm temperatures, high humidity, sea bathing, and wind, which contributes to disseminate the conidia. Despite Aspergillus niger has been reported as the main causative agent, A. flavus is predominant in Cadiz. Although infection is usually detected in warm months, we observed a homogeneous occurrence of otomycosis in almost all the seasons.
Tài liệu tham khảo
Yenia MM, al-Habib HM, Shehab NM. Otomycosis: a common problem in north Iraq. J Laryngol Otol. 1990;104:387–9.
Zaror L, Fischman O, Suzuki FA, Felipe RG. Otomycosis in Sao Paulo. Rev Inst Med Trop Sao Paulo. 1991;33:169–73.
Loh KS, Tan KK, Kumarasinghe G, Leong HK, Yeoh KH. Otitis externa the clinical pattern in a tertiary institution in Singapore. Ann Acad Med Singapore. 1998;27:215–8.
García-Martos P, García-Agudo R, Domínguez I, Noval JA. Otomicosis: aspectos clínicos y microbiológicos. Rev Diagn Biol. 2001;50:17–22.
Hueso Gutiérrez P, Jiménez Álvarez S, Gil-Carcedo Sañudo E, Gil-Carcedo García LM, Ramos Sánchez C, Valdezate Vallejo LA. Diagnóstico de presunción: Otomicosis. Estudio de 451 pacientes. Acta Otorrinolaringol Esp. 2005;56:181–6.
Pontes ZB, Silva AD, Lima Ede O, Guerra Mde H, Oliveira NM, Carvalho Mde F, Guerra FS. Otomycosis: a retrospective study. Braz J Otorhinolaryngol. 2009;75:367–70.
Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: a review. Int J Pediatr Otorhinolaryngol. 2008;72:453–9.
Aneja KR, Sharma C, Joshi R. Fungal infection of the ear; a common problem in the north eastern part of Hayana. Int J Pediatr Otorhinolaryngol. 2010;74:604–7.
Fasunla J, Ibekwe T, Onakoya P. Otomycosis in western Nigeria. Mycoses. 2008;51:67–70.
Araiza J, Canseco P, Bonifaz A. Otomycosis: clinical and mycological study of 97 cases. Rev Laryngol Otol Rhinol (Bord). 2006;127:251–4.
Pradhan B, Tuladhar NR, Amatya RM. Prevalence of otomycosis in outpatient department of otolaryngology in Tribhuvan University Teaching Hospital Katmandú, Nepal. Ann Otol Rhinol Laryngol. 2003;112:384–7.
Kaur R, Mittal N, Kaddar M, Aggarwal AK, Mathur MD. Otomycosis: a clinicomycologic study. Ear Nose Throat J. 2000;79:606–9.
Enweani IB, Igumbor H. Prevalence of otomycosis in malnourished children in Edo State, Nigeria. Mycopathologia. 1997;140:85–7.
Ho T, Vrabec JT, Yoo D, Coker NJ. Otomycosis: clinical features and treatment implications. Otolaryngol Head Neck Surg. 2006;135:787–91.
Ozcan KM, Ozcan M, Karaarsian A, Karaarsian F. Otomycosis in Turkey: predisposing factors, aetiology and therapy. J Laryngol Otol. 2003;117:39–42.
Martín AM, Canut A, Muñoz S, Pescador C, Gómez JL. Otomicosis: presentación de 15 casos. Enferm Infecc Microbiol Clin. 1989;7:248–51.
Vennewald I, Klemm E. Otomycosis: Diagnosis and treatment. Clin Dermatol. 2010;28:202–11.
Kurnatowski P, Filipiak A. Otomycosis: prevalence, clinical symptoms, therapeutic procedure. Mycoses. 2001;44:472–9.
Martin TJ, Kerschner JE, Flanary VA. Fungal causes of otitis externa and tympanostomy tube otorrhea. Int J Pediatr Otorhinolaryngol. 2005;69:1503–8.
Chander J, Maini S, Subrahmanyan S, Handa A. Otomicosis—a clinico-medical study and efficacy of mercurochrome in its treatment. Mycopathologia. 1996;135:9–12.
Gunnani HC, Okafor BC, Nzelibe F, Njoku-Obi AN. Etiological agents of otomycosis in Nigeria. Mycoses. 1989;32:224–9.
Hennequin C, Bez M, Trotoux J, Simonet M. Otomycose a Scopulariopsis brevicaulis apres tympanoplastie. Ann Otolaryngol Chir Cervicofac. 1994;111:353–4.
Yasin A, Maher A, Moawad MH. Otomycosis: a survey in the eastern province of Saudi Arabia. J Laryngol Otol. 1978;92:869–76.
Jain SK, Agrawal SC. Fungitoxic effect of some organic volatile substances against fungi causing otomycosis. Mycoses. 1994;37:299–301.
Barale T, Biévre C, Chobaut C, Cantenot A. A propos de la premiére souche de Tritirachium oryzae isolée au CHU de besacon. Bull Soc Fr Mycol Med. 1982;11:243–5.
Márquez A, García-Martos P, Marín P, Delgado D, García Cantos MD, Mira J. Otomicosis de etiología poco común. Enferm Infecc Microbiol Clin. 1999;17:243–5.
Baumgartner BJ, Rakita RM, Backous DD. Scedosporium apiospermum otomycosis. Am J Otoryngol. 2007;28:254–6.
Yenisehirli G, Bulut Y, Güven M, Günday E. In vitro activities of fluconazole, itraconazole and voriconazole against otomycotic fungal pathogens. J Laryngol Otol. 2009;123:978–81.
Dorko E, Jenca A, Orencák M, Virágová S, Pilipcinec E. Otomycoses of candidal origin in eastern Slovakia. Folia Microbiol (Praha). 2004;49:601–4.
Paulino Herrera A, Fernández Núñez JM, García Cruces Méndez J, Sánchez González F, Benito Arroyo I. Otomicosis. Presentación de 25 casos. Semergen. 1998;24:75–6.
Jenseca Z, Durkovs J, Rosinski I, Polak M, Zamboova E, Baca B. Filamentous micromycetes in otitis. Cesk Epidemol Mikrobiol Imunol. 1992;4:337–41.
Koening H, Biévre C, Waller J, Conraux C. Aspergillus alliaceus, agent d′otorrhée chronique. Bull Soc Fr Mycol. 1985;14:85–7.
Wadhwani K, Srivastava AK. Fungi from otitis media of agricultural field workers. Mycopathologia. 1984;88:155–9.
Bambule G, Savary M, Grigoriu D, Delacretaz J. Les otomycoses. Ann Oto-Laryngol. 1982;99:537–40.