Otomycosis in Western Iran: Clinical and Mycological Aspects

Otomycosis is a globally distributed superficial infection of the auricle and external auditory canal. Its incidence differs in various geographical regions due to the different climatic conditions.
The aim of this study was to determine the incidence of otomycosis in Khorramabad, Lorestan province, western Iran, using mycological besides clinical criteria.
In this cross-sectional descriptive study, a total of 79 patients clinically suspected to otomycosis were recruited from April 2014 to April 2015. Specimens were collected using sterile swabs. All the specimens were subjected to direct examination using 10% KOH, and culture in Sabouraud dextrose agar containing chloramphenicol, malt-extract agar, and Czapek Dox agar. CHROMagar candida and carbohydrate assimilation profile in API 32 C were used for the identification of yeasts.
Among 79 patients, 15 (19%) were confirmed for otomycosis. The most common agent was Candida albicans (5, 33.33%), followed by Aspergillus flavus (4, 26.64%), Penicillium spp. (3, 19.98%), A. niger (2, 13.32%), and Alternaria spp. (1, 6.66%). Females were the dominant involved group (11, 73.33%) and itching was the most frequent clinical compliant in 100% of cases with otomycosis.
Regarding the dissimilarity in fungal spectrum in our study and other investigations and unspecificity of clinical signs and symptoms for otomycosis, mycological examination could be a beneficial measure for accurate diagnosis and treatment of otomycosis.