Clinicopathological study of otomycosis in a tertiary hospital in South-west Nigeria

Abstract

Background: Otomycosis is common in environments with hot, humid weather, and it may be challenging to manage.

Objectives: To profile common clinical presentations, the pathogenic fungi, the treatment modalities with responses, and explore
clinical factors associated with having positive fungal culture in Otomycosis.

Methods: Retrospective review of patients with Otomycosis. Demographic and clinical parameters, otoscopic findings and
mycological study results were recorded. The treatment modalities used and treatment response were summarized. Comparative
statistical analyses of associated factors to positive fungal culture were performed with Chi square test, and Student’s t-test, using
SPSS version 22.0

Results: Total of 71 patients with M: F=1:1.8, mean age 38.5±19.8 years. Average duration of symptoms was 5.4 ±4.6 weeks;
common presenting complaint was itchy ear (33.8%). Majority of patients (85.9%) had unilateral ear involvement, 50.0% applied
ototopic medications before presentation, 8.5% had multiple co-morbidities. 20 patients had positive fungal culture results; common
fungal isolate was Aspergillus niger 9 (45.0%).
Clinical factors associated with positive culture of fungus were age, non-previous use of ototopic drugs, and presence of
co-morbidity. The most common treatment was local ear debridement and use of topical antifungal creams. Majority (91.5%)
of the patients responded with resolution of fungal infection. Complications rate was 8.4%.

Conclusions: Otomycosis commonly present with itchy ears, the pathogenic fungi commonly being Aspergillus species. The
factors associated with positive fungal culture were age, non-usage of ototopic agents and presence of co-morbidity. Treatment
modality used was local debridement and topical antifungal agents, which produced favourable response in most patients.

Keywords: Otomycosis; mycology; presentations; treatment; complications; associations.