Skip to main content
SpringerLink
Log in

Otomycosis due to Filamentous Fungi

  • Published:
Mycopathologia Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Yenia MM, al-Habib HM, Shehab NM. Otomycosis: a common problem in north Iraq. J Laryngol Otol. 1990;104:387–9.

    Google Scholar 

  2. Zaror L, Fischman O, Suzuki FA, Felipe RG. Otomycosis in Sao Paulo. Rev Inst Med Trop Sao Paulo. 1991;33:169–73.

    Article  PubMed  CAS  Google Scholar 

  3. 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.

    PubMed  CAS  Google Scholar 

  4. García-Martos P, García-Agudo R, Domínguez I, Noval JA. Otomicosis: aspectos clínicos y microbiológicos. Rev Diagn Biol. 2001;50:17–22.

    Google Scholar 

  5. 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.

    PubMed  Google Scholar 

  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.

    Article  PubMed  Google Scholar 

  7. Munguia R, Daniel SJ. Ototopical antifungals and otomycosis: a review. Int J Pediatr Otorhinolaryngol. 2008;72:453–9.

    Article  PubMed  Google Scholar 

  8. 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.

    Article  PubMed  CAS  Google Scholar 

  9. Fasunla J, Ibekwe T, Onakoya P. Otomycosis in western Nigeria. Mycoses. 2008;51:67–70.

    PubMed  Google Scholar 

  10. Araiza J, Canseco P, Bonifaz A. Otomycosis: clinical and mycological study of 97 cases. Rev Laryngol Otol Rhinol (Bord). 2006;127:251–4.

    CAS  Google Scholar 

  11. 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.

    PubMed  Google Scholar 

  12. Kaur R, Mittal N, Kaddar M, Aggarwal AK, Mathur MD. Otomycosis: a clinicomycologic study. Ear Nose Throat J. 2000;79:606–9.

    PubMed  CAS  Google Scholar 

  13. Enweani IB, Igumbor H. Prevalence of otomycosis in malnourished children in Edo State, Nigeria. Mycopathologia. 1997;140:85–7.

    Article  PubMed  Google Scholar 

  14. Ho T, Vrabec JT, Yoo D, Coker NJ. Otomycosis: clinical features and treatment implications. Otolaryngol Head Neck Surg. 2006;135:787–91.

    Article  PubMed  Google Scholar 

  15. Ozcan KM, Ozcan M, Karaarsian A, Karaarsian F. Otomycosis in Turkey: predisposing factors, aetiology and therapy. J Laryngol Otol. 2003;117:39–42.

    Article  PubMed  Google Scholar 

  16. Martín AM, Canut A, Muñoz S, Pescador C, Gómez JL. Otomicosis: presentación de 15 casos. Enferm Infecc Microbiol Clin. 1989;7:248–51.

    PubMed  Google Scholar 

  17. Vennewald I, Klemm E. Otomycosis: Diagnosis and treatment. Clin Dermatol. 2010;28:202–11.

    Article  PubMed  Google Scholar 

  18. Kurnatowski P, Filipiak A. Otomycosis: prevalence, clinical symptoms, therapeutic procedure. Mycoses. 2001;44:472–9.

    Article  PubMed  CAS  Google Scholar 

  19. Martin TJ, Kerschner JE, Flanary VA. Fungal causes of otitis externa and tympanostomy tube otorrhea. Int J Pediatr Otorhinolaryngol. 2005;69:1503–8.

    Article  PubMed  Google Scholar 

  20. 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.

    Article  PubMed  CAS  Google Scholar 

  21. Gunnani HC, Okafor BC, Nzelibe F, Njoku-Obi AN. Etiological agents of otomycosis in Nigeria. Mycoses. 1989;32:224–9.

    Article  Google Scholar 

  22. Hennequin C, Bez M, Trotoux J, Simonet M. Otomycose a Scopulariopsis brevicaulis apres tympanoplastie. Ann Otolaryngol Chir Cervicofac. 1994;111:353–4.

    PubMed  CAS  Google Scholar 

  23. Yasin A, Maher A, Moawad MH. Otomycosis: a survey in the eastern province of Saudi Arabia. J Laryngol Otol. 1978;92:869–76.

    Article  Google Scholar 

  24. Jain SK, Agrawal SC. Fungitoxic effect of some organic volatile substances against fungi causing otomycosis. Mycoses. 1994;37:299–301.

    Article  PubMed  CAS  Google Scholar 

  25. 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.

    Google Scholar 

  26. 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.

    PubMed  Google Scholar 

  27. Baumgartner BJ, Rakita RM, Backous DD. Scedosporium apiospermum otomycosis. Am J Otoryngol. 2007;28:254–6.

    Article  Google Scholar 

  28. 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.

    Article  PubMed  CAS  Google Scholar 

  29. Dorko E, Jenca A, Orencák M, Virágová S, Pilipcinec E. Otomycoses of candidal origin in eastern Slovakia. Folia Microbiol (Praha). 2004;49:601–4.

    Article  CAS  Google Scholar 

  30. 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.

    Google Scholar 

  31. Jenseca Z, Durkovs J, Rosinski I, Polak M, Zamboova E, Baca B. Filamentous micromycetes in otitis. Cesk Epidemol Mikrobiol Imunol. 1992;4:337–41.

    Google Scholar 

  32. Koening H, Biévre C, Waller J, Conraux C. Aspergillus alliaceus, agent d′otorrhée chronique. Bull Soc Fr Mycol. 1985;14:85–7.

    Google Scholar 

  33. Wadhwani K, Srivastava AK. Fungi from otitis media of agricultural field workers. Mycopathologia. 1984;88:155–9.

    Article  PubMed  CAS  Google Scholar 

  34. Bambule G, Savary M, Grigoriu D, Delacretaz J. Les otomycoses. Ann Oto-Laryngol. 1982;99:537–40.

    CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Clinical Microbiology Laboratory, Puerta del Mar University Hospital, Avda. Ana de Viya, 21, 11009, Cádiz, Spain

    Lidia García-Agudo, Pilar Aznar-Marín, Fátima Galán-Sánchez, Pedro García-Martos, Pilar Marín-Casanova & Manuel Rodríguez-Iglesias

Authors
  1. Lidia García-Agudo
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Pilar Aznar-Marín
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Fátima Galán-Sánchez
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Pedro García-Martos
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Pilar Marín-Casanova
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Manuel Rodríguez-Iglesias
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Manuel Rodríguez-Iglesias.

Rights and permissions

Reprints and permissions

About this article

Cite this article

García-Agudo, L., Aznar-Marín, P., Galán-Sánchez, F. et al. Otomycosis due to Filamentous Fungi. Mycopathologia 172, 307–310 (2011). https://doi.org/10.1007/s11046-011-9427-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11046-011-9427-5

Keywords

Search

Navigation