Otomycosis in Southern China: a retrospective analysis of clinical presentation, otoendoscopic features, and...

Otomycosis is a common fungal infection of the external auditory canal (EAC), with a higher incidence in tropical and subtropical regions. Epidemiological information on otomycosis in southern China is limited. This study aimed to characterize the clinical manifestations, otoendoscopic features, and pathogen distribution of otomycosis in southern China.

A retrospective analysis was conducted of 192 confirmed cases of otomycosis among patients at a tertiary hospital in Guangzhou, southern China.

The most common presentation was ear pruritus, followed by hearing loss, aural fullness, otorrhea, tinnitus, and otalgia. Unilateral infection was more common than bilateral infection. The EAC was the primary site affected. Characteristic findings included crusts, congestion, fungoid substance, exudate, and swelling. These features (especially crusts, congestion, swelling, and fungoid substance) were significantly associated with fungal positivity. Of the 110 cases in which fungal pathogens were identified, the majority (103, 93.64%) were Aspergillus species including A. terreus (n = 69), A. flavus (n = 16), A. niger (n = 13), A. sclerotiorum (n = 2), A. oryzae (n = 1), A. sydowii (n = 1) and A. tamarii (n = 1); Candida species accounted for 4 isolates (3.64%), and one isolate each was identified for Cladophialophora, Trichophyton, and Scopulariopsis species (0.91%).

These findings provide region-specific insights that are crucial for guiding effective clinical diagnosis, prevention and empirical antifungal therapy. Antifungal therapy covering Aspergillus should be prioritized in this high-incidence area.