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Otomycosis in the South of Iran with a High Prevalence of Tympanic Membrane Perforation: A Hospital-Based Study

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Abstract

Introduction

Otomycosis is a superficial infection of the external ear caused by fungal pathogens. The genera Aspergillus and Candida are considered the main fungal causative agents, with the predominance of Aspergillus section Nigri. The present study aimed to evaluate the clinical symptoms of patients with otomycosis and predisposing factors and to identify fungal etiological agents using molecular approaches. We also present an overview of published papers on tympanic membrane perforation (TMP) secondary to otomycosis.

Materials and Methods

An otorhinolaryngologist collected specimens from external ear canals of patients with suspected otomycosis based on the patient’s history and clinical examinations. The specimens were collected using sterile swabs. Fungal isolates were confirmed in clinical specimens by direct microscopy and culture methods. Fungal isolates were identified based on molecular approaches.

Results

In total, specimens from 211 patients with suspected otomycosis were examined. The presence of fungi was confirmed in about 51% of patients based on fungal elements in direct microscopy and culture-positive fungi. Aspergillus tubingensis was the most commonly isolated species (52.77%), followed by Aspergillus niger (25.92%). Otomycosis due to infection with Candida species was observed in 16% of cases. Of note, in 36.11% of cases, otomycosis was associated with TMP.

Conclusion

A mycological examination is indispensable for a correct diagnosis in patients with otitis extern. TMP should be considered in patients with otomycosis, as it appears to be relatively common in this population.

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Acknowledgements

We would like to thank Dr. Reza Rouhi Sefidmazgi from Department of Medical Otorhinolaryngology, Jahrom University of Medical Sciences, Jahrom, Iran for collaborating on this project.

Funding

This work was supported by Jahrom University of Medical Sciences Deputy of Research, Jahrom, Iran (Grant No. 99000344).

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Authors and Affiliations

  1. Student Research Committee Center, Mazandaran University of Medical Sciences, Sari, Iran

    Javad Javidnia

  2. Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran

    Javad Javidnia

  3. Zoonosis Research Center, Jahrom University of Medical Sciences, Jahrom, Iran

    Zahra Ghotbi, Kavous Solhjoo & Gholamreza Shokoohi

  4. Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran

    Zahra Ghotbi, Kavous Solhjoo & Gholamreza Shokoohi

  5. Department of Medical Mycology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran

    Aynaz Ghojoghi

  6. Teikyo University Institute of Medical Mycology, Tokyo, Japan

    Mohamed Mahdi Alshahni

  7. Department of Laboratory Sciences, School of Allied Medical Sciences, Abadan University of Medical Sciences, Abadan, Iran

    Seyed Ali Jeddi

  8. Department of Medical Laboratory Sciences, Faculty of Paramedical, Bushehr University of Medical Sciences, Bushehr, Iran

    Bahram Ahmadi

  9. Cellular and Molecular Research Center, Yasuj University of Medical Sciences, Yasuj, Iran

    Sadegh Nouripour-Sisakht

  10. Department of Parasitology and Mycology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran

    Saham Ansari

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  1. Javad Javidnia
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Correspondence to Gholamreza Shokoohi.

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This research was approved by the Ethics Committee of the Jahrom University of Medical Sciences, Jahrom, Iran (Approval Code: IR.JUMS.REC.1397.062).

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Javidnia, J., Ghotbi, Z., Ghojoghi, A. et al. Otomycosis in the South of Iran with a High Prevalence of Tympanic Membrane Perforation: A Hospital-Based Study. Mycopathologia 187, 225–233 (2022). https://doi.org/10.1007/s11046-022-00626-9

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