Clinical Presentations, Cluster Analysis and Laboratory-Based Investigation of Aspergillus Otomycosis-A Single Center...

Area of Science:

• Mycology
• Infectious Diseases
• Otolaryngology

Background:

• Species within the Aspergillus niger and Aspergillus flavus complexes are primary fungal agents responsible for otomycosis.
• Understanding the clinical course, diagnosis, and relapse patterns of Aspergillus-induced otomycosis is crucial for effective patient management.

Purpose of the Study:

• To investigate the clinical presentation, diagnostic methods, and relapse characteristics of otomycosis caused by Aspergillus species.
• To assess the biofilm production capability of Aspergillus species isolated from patients experiencing relapse.

Main Methods:

• A cohort of 30 patients with laboratory-confirmed Aspergillus-otomycosis was followed for 60 days post-treatment initiation.
• Standard mycological procedures were used for Aspergillus species isolation and identification.
• Biofilm production was evaluated using a modified Pierce and Kvasničková method.

Main Results:

• Microscopy demonstrated high sensitivity for Aspergillus detection, though some species required specific cultivation temperatures (27-28 °C).
• Statistical analysis identified a distinct patient group with Aspergillus niger complex-otomycosis.
• Six patients experienced relapse with the same Aspergillus species; all isolated species from relapsed cases exhibited biofilm production.

Conclusions:

• Aspergillus species causing otomycosis, particularly those capable of biofilm formation, can lead to disease relapse.
• The study underscores the need for standardized diagnostic criteria and recommendations to prevent misdiagnosis and prolonged/complicated infections.