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The changing nature of paediatric otomycosis in the mid-west of Ireland
D Westby1, N O'Connell2, J Powell2
1Department of Surgery, University Hospital Limerick, Ireland.
Insights
The incidence of pediatric otomycosis is rising, with Candida species being the most common cause, unlike previous findings. Increased use of topical fluoroquinolones correlates with this trend.
Area of Science:
- Otolaryngology
- Mycology
- Pediatric Infectious Diseases
Background:
- Fungal otitis externa (otomycosis) is common in tropical regions.
- An increasing prevalence of pediatric otomycosis has been observed in temperate climates.
- This study reviews pediatric otomycosis cases at University Hospital Limerick.
Purpose of the Study:
- To determine the frequency of pediatric otomycosis.
- To identify causative fungal organisms.
- To investigate predisposing factors and management strategies.
Main Methods:
- Retrospective review of pediatric patients diagnosed with otomycosis from 2001 to 2015.
- Identification of patients with positive fungal ear swabs.
Main Results:
- Candida species were the most common fungal isolate (93 patients, mean age 5.8 years).
- Aspergillus species were identified in 10 patients (mean age 9.1 years).
- A positive correlation was found between otomycosis diagnosis and prior topical fluoroquinolone use (r = 0.8; p < 0.01).
Conclusions:
- Pediatric otomycosis incidence has increased since 2001.
- This rise correlates with increased topical fluoroquinolone usage.
- Candida, not Aspergillus, is the predominant cause of otomycosis in this pediatric cohort.
Background:
Fungal otitis externa is prevalent in tropical and sub-tropical climates; however, over the past two decades, there has been a reported increase in the prevalence of otomycosis in paediatric patients from more temperate climates. This study aimed to review the children diagnosed with otomycosis at the University Hospital Limerick with reference to frequency, causative organism, predisposing factors and management.
Methods:
A retrospective review was conducted of paediatric patients from 2001 to 2015. Patients with positive fungal ear swabs and a diagnosis of otomycosis were identified.
Results:
Ninety-three patients were positive for candida (mean age, 5.8 years), 10 patients were positive for aspergillus (mean age, 9.1 years) and 1 patient had mixed fungal infection containing both fungi. There was a positive correlation between a diagnosis of otomycosis and prior treatment with topical fluoroquinolones (r = 0.8; p < 0.01).
Conclusion:
The incidence of otomycosis has been increasing since 2001, which correlates with an increase in the use of topical fluoroquinolones. Previous studies identify aspergillus as the commonest causative fungi; however, this study found that candida was the commonest isolated fungi in the paediatric population.
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