A CLINICO-MYCOLOGICAL STUDY OF OTOMYCOSIS FROM A TERTIARY CARE HOSPITAL IN WESTERN UTTAR PRADESH
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 45
Abstract
BACKGROUND The term otomycosis simply refers to superficial fungal infection of the external auditory canal. Most patients suffering from early otomycosis complain of severe itching which often progress to pain, hearing loss and tympanic membrane perforation. Aims- To determine the predisposing factors, symptoms and to identify the fungus and secondary bacterial infection associated with it. MATERIALS AND METHODS A total of 100 consecutive patients with clinical diagnosis of otomycosis were considered as the study group and 100 consecutive patients with no diagnosis of otomycosis were considered as the control group from a total of 200 individuals attending the Outpatient Department of ENT at Chhatrapati Shivaji Subharti Hospital (CSSH), a tertiary care teaching hospital in Meerut City, were chosen for the study. RESULTS History of wooden stick or any other object used to remove wax (68%), use of oil (44%), swimming (28%) and history of trauma (23%) were the common predisposing factors in otomycosis. Pruritus and otalgia (89% each) were the most common complaints. Statistical association (p value<0.001) was found between isolation of fungi and otomycosis whereas no statistical association was found between otomycosis and bacterial association. The fungi isolated were mainly Aspergillus niger (77.0%) followed by A. flavus (12.6%), A. terreus (4.6%), Candida guilliermondii and C. krusei (1.1% each). Bacterial isolates were Staphylococcus epidermidis (21%), S. aureus (7%), Klebsiella pneumoniae (2%) and Enterobacter aerogenes (1%). Fungal pathogens were isolated from external auditory canal of 8% of controls. CONCLUSION Pruritis and otalgia (89% each) were the common complaints followed by discharge, tinnitus and hearing loss. Aspergillus (94.2%) was the most common isolate from otomycosis in our study, followed by Candida (2.3%) as in studies across the world. Isolation of Aspergillus spp. such as A. terreus isolate is important, as they are largely resistant to antifungal drug Amphotericin B. It usually resolves with aural toilet and installation of antifungal drugs. Recurrence of the disease is common after treatment. We had a recurrence rate of 20% as compared to 5% quoted in literature. This may be due to patients having poor hygiene, diabetes mellitus, community bathing and poor compliance to treatment.
Authors and Affiliations
Sanjiv Ahuja, Anshul Bansal, Anita Pandey, Molly Madan, Deepak Kumar Gupta
Keywords
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- EP ID EP216794
- DOI 10.14260/Jemds/2017/754
- Views 70
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