THE ROLE OF FUNGAL INFECTION IN RECURRENT ACUTE DIFFUSE OTITIS EXTERNA
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Recurrent acute otitis extema is one of the most common clinical problems in E.N.T clinical practice especially during summer seasons in our communities. Hidden or unclercliagnosed fungal infection is thought to be a clinical problem that may be responsible for recurrent inflammation and patient unsatisfaction. Purpose: This study aimed to check the role of fungal infection in cases of recurrent acute diffuse otitis externa and to identify the most common causative organisms in our community and their antimicrobial sensitivity. Patients and methods: This study was held in Otorhinolaryngology and Microbiology tind Immunology Departments, Faculty of Medicine, Benha University, in the period from March 2011 to January 2012 on 100 patients complaining of recurrent otalgia and were diagnosed to have recurrent acute diffuse otitis extema. Three samples were collected from the external auditory canal of each patient with the help of sterile cotton swabs. The first swab was for direct microscopic examination, the second for fungal isolation by culture, and the third was for bacterial isolation by culture. Antibiotic and antifungal sensitivities were performed for isolated bacteria and fungi respectively. Results: The present study showed that otitis extema bacterial infection represented 61% as single pathogen and otitis extema fungal infection represented 32% as single pathogen and otitis extema mixed infection represented 7%. Conclusions: Otomycosis is an underdiagnosed problem in the management of recurrent acute otitis extema. It is recommended to depend on the results of microbiological and sensitivity tests in the management of recurrent otitis extema and also it is recommended to include antifungal in the empirical treatment of these cases.