Abstract
Otomycosis is a superficial, sub-acute or chronic infection of the external auditory canal, characterized by pruritis, inflammation, pain and itching commonly seen in tropical and subtropical regions of the world. Various host and environmental factors can predispose a person to otomycosis. However, a clinical presentation along with otoscopic observations of the patients shows fungal and bacterial infections. Proper identification of causative agents is necessary in order to prevent recurrences and complications such as hearing lost. The aim of our study was to determine the fungi and bacteria pathogens causing otomycosis and to derive association of risk factors with otomycosis of the clinically diagnosed patients. A descriptive cross-sectional study was conducted in the otorhinolaryngology department at the University Teaching hospital and the Central hospital over a period of one year. A total of 250 clinically diagnosed patients of otomycosis of age above one year were included in the study. We evaluated age and sex distribution, predisposing factors and complaints of the clinically diagnosed patients for otomycosis. All samples collected were transported and evaluated by both direct microscopic examination and culture method for bacteria and fungi examination, which were identified by standard procedures. Among 250 samples, 46.22% yielded fungal growth, 21.33% grew bacteria only and 32.44% showed mixed growth of fungi and bacteria. Major fungal isolates were <i>Aspergillus</i> (n=121) including 75 isolates of <i>Aspergillus</i> section <i>Nigri</i>, 20 isolates of <i>Aspergillus</i> section <i>Flavi</i>, 13 isolates of <i>Aspergillus</i> section <i>Fumigati</i>, 8 isolates of <i>Aspergillus</i> section <i>Nudilante</i> and 5 isolates of <i>Aspergillus</i> section <i>Terrei</i>. 48 isolates were identified as <i>Candida</i> species. Major bacterial isolates were <i>Staphylococcus aureus</i> (n=45) followed by <i>Pseudomonas</i> species (n=26), <i>Klebsiella</i> species (n=21), <i>Escherichia coli</i> (n=7) and <i>Proteus</i> species (n=3). This study highlights the highest isolation of <i>Aspergillus</i> section <i>Nigri</i> in cases of clinically diagnosed otomycosis patients at the two reference hospital in Yaoundé, Cameroon with high prevalence seen in patients using antibiotic eardrops as a mean of treatment from pains and itching.
Highlights
Otomycosis is a sub acute or chronic fungal infection of the external auditory canal with some complications involving the middle ear [1]
Out of 250 cases, 121 cases were in 21-40 years of age group constituting maximum of (48.4%) of the cases clinically diagnosed of otomycosis
Outstanding to the varied microbiological flora of the ear, both fungi and bacteria are involved in otomycosis causing a mixed infection which can be bilateral or unilateral, early diagnosis is of paramount importance to guide proper treatment
Summary
Otomycosis is a sub acute or chronic fungal infection of the external auditory canal with some complications involving the middle ear [1]. It occurs because the protective lipid/acid balance of the ear is lost [2]. It is estimated that approximately 25% of the total cases of ear infections are due to fungi, and the disease is more prevalent in warm and humid climates [3]. The fungus may not be the primary cause but merely a secondary invader in cases of otitis externa. Otomycosis can be seen in mixed fungal with bacterial infections [5]
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