A study on associated otomycosis in chronic suppurative otitis media patients in a tertiaty care hospital

Robin Richards, M (2018) A study on associated otomycosis in chronic suppurative otitis media patients in a tertiaty care hospital. Masters thesis, Madurai Medical College, Madurai.


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INTRODUCTION: Otomycosis is worldwide in distribution and in various recorded series, it has accounted for 5 to 20% of all cases of infective otitis externa. It is one of the commonest manifestations in India during rainy season. It occurs mostly in humid atmosphere. Chronic suppurative otitis media causes recurrent ear discharge and perforation of the ear drum, requiring long term treatment and follow up. Fungal infections on chronic suppurative otitis media is suspected when the discharging ear does not respond to the local antibiotic ear drops. AIM AND OBJECTIVES: 1. To identify mycological agents in the discharging ear of Chronic Suppurative otitis media patients. 2. To find distribution of fungal aetiology in Chronic Suppurative Otitis Media. 3. To analyse the relation of local antibiotics, antibiotics with steroids and antibiotics & antifungals with steroids in fungal growth occurring in Chronic Suppurative otitis media patients. MATERIALS AND METHODS: Patients presenting with symptoms and signs of Chronic Suppurative otitis media were being selected as the study population. The study was conducted on 150 cases on patients attending ENT Out Patient Department at Government Rajaji Hospital, Madurai. The clinical diagnosis was based on ear discharge, ear itching sensation, ear blocking sensation and the fungal debris in the ear canal. Inclusion Criteria: Patients with Chronic Suppurative Otitis Media with Active Discharge. Patients presenting with ear discharge, ear pain, ear itching sensation. Age of above 12 years. All sexes. RESULTS: A total of 150 cases of Chronic Suppurative Otitis Media patients were selected for this study, from Department of ENT, Government Rajaji Hospital, Madurai for a period of one year ti om 2016 to 2017. Among 150 patients with chronic suppurative otitis media, 22 patients had an associated otomycosis. Among 20 Aspergillus isolates, 16 isolates (80%) of Aspergillus niger, 3 isolates (15%) of Aspergillus Banns, 1 isolate (5%) of Aspergillus fumigatus were detected. Aspergillus niger species was the most common Aspergillus species detected. The patients were being followed up each week for a period of 8 weeks by otoscopic examination of ear. After 8 weeks, fungal swab was taken again and checked for the presence of fungalspecies. The presence of fungal species were compared with the three groups and the results were evaluated. In group A among 50 persons who were administering antibiotics, 12 persons (24%) had Aspergillus isolated. In group B, among 50 persons who were administering antibiotics with steroids, 22 persons had fungal isolates. Among 22 persons, 20 (40%) were isolates of Aspergillus species and 2 (4%) were isolates of Candida species. In group C, among 50 patients who were administering antibiotics and antifungals with steroids, no isolates of fungus were isolated. CONCLUSION : Most common fungus isolated in chronic suppurative otitis media was Aspergillus. Most common Aspergillus species isolated in chronic suppurative otitis media was Aspergillus niger. The antibiotic drop apart from moist and alkaline medium of discharge appears to be mainly responsible for fungal growth and when steroids are added the fungal growth incidence is increased. Thus local drops should be used with great care in treating chronic suppurative otitis media. Local antibiotic drops with anti- fungal agents may be the ideal treatment in chronic cases.

Item Type: Thesis (Masters)
Uncontrolled Keywords: Apergillus ; otomycosis ; chronic suppurative otitis media.
Subjects: MEDICAL > Otolaryngology
Depositing User: Subramani R
Date Deposited: 15 Jul 2018 09:02
Last Modified: 05 Jan 2019 03:59
URI: http://repository-tnmgrmu.ac.in/id/eprint/8825

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