Etiology, Predisposing Factors, Clinical Features and Diagnostic Procedure of Otomycosis: A Literature Review

Author:

Bojanović Mila12ORCID,Stalević Marko3ORCID,Arsić-Arsenijević Valentina4ORCID,Ignjatović Aleksandra15ORCID,Ranđelović Marina15ORCID,Golubović Milan2ORCID,Živković-Marinkov Emilija12,Koraćević Goran12,Stamenković Bojana16ORCID,Otašević Suzana15ORCID

Affiliation:

1. Medical Faculty, University of Niš, 18000 Niš, Serbia

2. University Clinical Center Niš, 18000 Niš, Serbia

3. Medical Faculty, University of Priština in Kosovska Mitrovica, 38220 Kosovska Mitrovica, Serbia

4. Medical Faculty, University of Belgrade, 11000 Belgrade, Serbia

5. Public Health Institute Niš, 18000 Niš, Serbia

6. Institute For Treatment and Rehabilitation “Niška Banja”, 18205 Niš, Serbia

Abstract

Otomycosis (OM) is a superficial fungal infection of the external auditory canal (EAC) with a worldwide prevalence ranging from 9% to 30%. Commonly, otomycoses are caused by Aspergillus (A.) niger complex and Candida spp. Other causative agents are yeasts of the genera Cryptococcus spp., Rhodotorula spp., Geotrichum candidum, dermatophytes (Trichophyton mentagrophytes), and non-dermatophytes molds (Fusarium spp., Penicillium spp., Mucorales fungi). The widest range of different species causing OM are found in the territories of Iran, India, China, Egypt, Mexico, and Brazil. Fungal infection of the EAC varies from mild to severe forms. It can be acute, subacute, or chronic, and is often unilateral, while the bilateral form is more common in immunocompromised patients. From an epidemiological point of view, tropical and subtropical climates are the most significant risk factor for the development of otomycosis. Other predisposing conditions include clothing habits, EAC hygiene practices, long-term antibiotic therapy, diabetes, and immunodeficiency. Since it is often difficult to distinguish otomycosis from an infection of a different origin, laboratory-based evidence, including standard procedures (microscopy and cultivation), is essential for diagnosis. For the treatment of this superficial fungal infection, there are no official therapeutic guidelines and protocols. However, many antifungals for local application, such as polyene, imidazoles, and allylamines, can be applied, as well as systemic antimycotics (triazoles) in severe forms of infection.

Funder

Science Fund of the Republic of Serbia

Publisher

MDPI AG

Subject

Plant Science,Ecology, Evolution, Behavior and Systematics,Microbiology (medical)

Reference63 articles.

1. Otomycosis in western Nigeria;Fasunla;Mycoses,2008

2. Otomycosis in a Rural Community Attending a Tertiary Care Hospital: Assessment of Risk Factors and Identification of Fungal and Bacterial Agents;Agarwal;J. Clin. Diagn. Res.,2017

3. Comparison of the recovery rate of otomycosis using betadine and clotrimazole topical treatment;Mofatteh;Braz. J. Otorhinolaryngol.,2018

4. Species distribution patterns and epidemiological characteristics of otomycosis in Southeastern Serbia;J. De Mycol. Médicale,2020

5. Black aspergilli as causes of otomycosis in the era of molecular diagnostics, a mini-review;Seifi;J. Mycol. Med.,2022

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