Otomycosis among Patients Presenting with Ear Discharges at a Tertiary Hospital in South Western Uganda

Abstract

Aims: To the determine prevalence, mycology profile, associated symptoms and risk factors of otomycosis among patients that present with an ear discharge. Study Design:  This was a cross-sectional study in which survey data was analysed. Place and Duration of Study: Departments of Microbiology and ENT, Faculty of Medicine, Mbarara University Teaching Hospital, between 2013 and 2015. Methodology: We recruited 117 patients (52 men, 65 women of age range 1-69 years) presenting with a discharging ear. Both newly enrolled and follow-up patients were included in the study. Clinically, patients were assessed for symptoms, possible predisposing factors, and treatment history. For laboratory diagnosis, ear swabs were aseptically collected and mycology profile determined using both direct examination and culture techniques. Fungal identification was through stimulation of fruiting bodies such as conidia or chlamydospores and biochemical identification. Results: Of the 117 participants enrolled, fungal infection was detected in 24 (20.51%) with direct microscopy and confirmed in 16 (13.68%) by culture.  Otomycosis was more common among the youth (54%). There were no statistically significant symptoms associated with otomycosis. However, HIV/AIDS and mastoidectomy were significant predisposing factors (38%, p = 0.001 and 25%, p = 0.002, respectively). Aspergillus species (76.47%), Candida albicans (17.65%) and Cladosporium species (5.88%) were the agents commonly associated with otomycosis in this region.  Conclusion: Otomycosis can be common and is an important disease of the external ear, especially in at-risk individuals. In southwestern Uganda, the disease is common among young males and aetiology is mainly due to Aspergillus and Candida albicans but other opportunists such as Cladosporium species may also be implicated. Thus, there is a need for routine checks followed by robust diagnostic approaches as a means for evidence-based patient management.