Outer Ear Infections in Iran: A Review

Keyvan Kiakojuri; Mojtaba Taghizadeh Armaki; Ramazan Rajabnia; Abazar Pournajaf; Mohsen Karami; Aynaz Khademian; Saeid Mahdavi Omran

doi:10.3889/oamjms.2019.176

Authors

Keyvan Kiakojuri Department of Ear, Nose, and Throat, School of Medicine, Roohani Hospital, Babol University of Medical Sciences, Babol, Iran
Mojtaba Taghizadeh Armaki Infectious Diseases and Tropical Medicine Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran; Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Ramazan Rajabnia Infectious Diseases and Tropical Medicine Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran; Department of Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Abazar Pournajaf Infectious Diseases and Tropical Medicine Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran; Department of Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Mohsen Karami Infectious Diseases and Tropical Medicine Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran; Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Aynaz Khademian Department of Microbiology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
Saeid Mahdavi Omran Infectious Diseases and Tropical Medicine Research Center, Health Research Center, Babol University of Medical Sciences, Babol, Iran; Department of Medical Parasitology and Mycology, School of Medicine, Babol University of Medical Sciences, Babol, Iran

DOI:

https://doi.org/10.3889/oamjms.2019.176

Keywords:

Outer Ear, Fungal infection, Bacterial infection, Bacterial-fungal infections

Abstract

BACKGROUND: Otitis externa is the fungal and bacterial infection of the outer ear.

AIM: We aimed to investigate the published papers about the outer ear infections in Iran and suggest standardised investigations and treatments.

METHODS: We used different electronic databases like PubMed, Scopus, Web of Science, Iranmedex, Google Scholar, and Magiran with specific keywords.

RESULTS: We obtained forty published full-text articles for review of data. Our results indicated the women were more infected than men. The ages of patients were < 1-81 years. As clinically symptoms, itching and Feel the ear fairy were the most common presenting complaints in most cases. Most infections were the pure bacterial and fungal origin, respectively. However, some of the studies were mixed fungal-bacterial infections â€” Pseudomonas spp. And Aspergillus niger were the most common bacteria and fungi isolates respectively in Iranian patents.

CONCLUSION: Fungal and bacterial specific cultures may be recommended, and anti-fungal drugs may be added, to treatment regimens in patients with otitis externa to reduce the clinical symptoms.

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References

Ong YK, Chee G. Infection of the external ear. Ann Acad Med Singapore. 2005; 34(4):330-4. PMid:15937574

Hirsch BE. Infections of the external ear. Am J Otolaryngol. 1992; 13(3):145-55. https://doi.org/10.1016/0196-0709(92)90115-A

Kiakojuri K, Nazari M, Rajabnia R, Khafri S, Mahdavi Omran S. The evaluation of the causes of otitis externa in children referring to the ENT clinic of Ayatollah Rohani Hospital of Babol, 2013-14. J Babol Univ Med Sci. 2015; 17(5):25-30.

Kiakojuri K, Mahdavi Omran S, Jalili B, Hajiahmadi M, Bagheri M, Ferdousi Shahandashti E, et al. Bacterial otitis externa in patients attending an ENT clinic in Babol, North of Iran. Jundishapur J Microbiol. 2016; 9(2):e23093. https://doi.org/10.5812/jjm.23093 PMid:27127584 PMCid:PMC4841979

Nemati SH, Hassanzadeh R, Khajeh Jahromi S, Delkhosh Nasrollah Abadi A. Otomycosis in the north of Iran: common pathogens and resistance to antifungal agents. Eur Arch Otorhinolaryngol. 2014; 271(5):953-7. https://doi.org/10.1007/s00405-013-2486-0 PMid:23595615

Mehdinejad M, Khosravi AD, and Mahmoudabadi AZ. Study of bacterial flora in children,s with hearing aid earmoulds in Ahvaz, Iran. Pak J Biol Sci. 2010; 13(5):245-8. https://doi.org/10.3923/pjbs.2010.245.248 PMid:20464948

Kochak Alavi SK, Irajian GH, Beheshti AS, Bineshian F, Hajighorbani AH. The freguency of bacterial agents in otitis externa from Semnan seneitivity test (2000-2003). Semnan J Med Sci. 2004; 6(2):135-9.

Shokohi T, Ahanjan M, Kasiri A. The microbiology and mycology survey of otitis externa in Bu Ali Sina ear nose and throut clinic, Sari. J Mazandaran Univ Med Sci. 2001; 11(32):1-9.

Akhi MT, Ahmadian A, Nejadkazem M, Ramazanzadeh R. Study on an aerobic bacteria isolated from otitis externa and some predisposing factors (Tabriz. 1998). Tabriz J Med Sci. 2001; 35(52):5-10.

Kiakojori K, Gooran AK, Rajabnia R, Mahdavi Omran S. A study on the effectiveness of boericke alcohol and miconazole ointment for the prevention of outer ear infections after suction clearane. J Babol Univ Med Sci. 2015; 17(4):29-35.

Mahdavi Omran S, Jalili B, Rajabnia R, and Kiakojuri K. clinical and demographical findings of otitis externa in adult patients who referred to Roohani Hospital, Babol, Iran. Int J Curr Microbiol App Sci. 2015; 4(5):133-9.

Barati B, Okhovvat SAR, Goljanian A, Omrani MR. Otomycosis in central Iran: a clinical and mycological study. Iran Red Crescent Med J. 2011; 13(12):873-6. PMid:22737432 PMCid:PMC3371907

Ebrahimzadeh A, Mousavi M. Fungal flora in external ear canal in chronic otitis media. J Gorgan Univ Med Sci. 2014; 16(3):122-6.

Bineshian F, Irajian GH, Koochak- Alavi SK, Fredonian MR. A study on the frequency of fungal agents in otitis externa in Semnan. Iran J Pathol. 2006; 1(4):141-4.

Kiakojuri K, Rajabnia R, Jalili B, Khafri S, Mahdavi Omran S. Otomycosis in adolescent patients referred to the therapeutic centers in Babol city, Iran. Jundishapur J Microbiol. 2015; 8(5):e17138. https://doi.org/10.5812/jjm.8(5)2015.17138

Nowrozi H, Doustdar Arabi F, Ghaffarnejad Mehraban H, Tavakoli A, Ghooshchi GH. Mycological and clinical study of otomycosis in Tehran, Iran. Bull Env Pharmaco Life Sci. 2014; 3(2):29-31.

Golshiri A, Mokhtaree MR, Bahramabadi R, Shabani Z, Sayadi A, Abbasi A. Prevalence of microbial agents and pattern of antimicrobial resistance in patients with acute otitis externa in Rafsanjan in 2011. Com Health J. 2014; 7(4):10-7.

Balouchi M, Berjis N, Okhovat AR. The frequency of fungul infections of externa ear. Isfahan Med J. 2006; 24(82):72-5.

Zarei Mahmoudabadi A. Mycological studies in 15 cases of otomycosis. Pak J Med sci. 2006; 22(4):486-8.

Zarei Mahmoudabadi A, Masoomi SA, Mohammadi H. Clinical and mycological studies of otomycosis. Pak J Med Sci. 2010; 26(1):187-90.

Berjis N, Okhovat SA, Soleimani Koujani Z, Baradaran SH. Comparing the therapeutic effect of clotrimazole and tolnaftate in treating variety of fungal species producing otomycosis in Alzahra and Kashani Hospitals, Iran. J Isfahan Med Sch. 2012; 29(164):1831-41.

Saki N, Rafiei A, Nikakhlagh S, Amirrajab N, Saki S. Prevalence of otomycosis in khouzestan province, south- west Iran. J Laryngol Otol. 2013; 127(1):25-7. https://doi.org/10.1017/S0022215112002277 PMid:23164073

Kiakojuri K, Hasanjani Roshan MR, Sepidgar SAA. Suction clearance and 2% topical miconazole versus the same combination with acidic drops in the treatment of otomycosis Southeast Asian J Trop Med Public Health. 2007; 38(4):749-53. PMid:17883017

Yeganeh Moghadam A, Asadi MA, Dehghani R, Hooshyar H. The Prevalence of otomycasis in Kashan, Iran, during 2001-2003. Jundishapour J Microbiol. 2009; 2(1):18-21.

Kazemi A, Majidinia M, Jaafari A, Ayatollahi Mousavi SA, Zarei Mahmoudabadi A, and Alikhah H. Etiologic agents of otomycosis in the north- western area of Iran. Jundishapur J Microbiol. 2015; 8(9):e21776. https://doi.org/10.5812/jjm.21776 PMid:26495108 PMCid:PMC4609173

Afshari MA, Kachuei R, Ajal Loueial M. The frequencey of otomycosis in pateints who reffered to ENT clinic, Baghiatolah Hospital. Teb Nezami. 2005; 7(2):121-4.

Gharaghani M, Seifi Z, Zarei Mahmoudabadi A. Otomycosis in Iran: a review. Mycopathologia. 2015; 179(5-6):415-24. https://doi.org/10.1007/s11046-015-9864-7 PMid:25633436

Kiakojuri K, Mahdavi Omran S, Rajabnia R, Asgarzadeh SH. Inhibitory effect of cerumen of fungi with potential of otomycosis Iran J of Otorhinolaryngol. 2010; 22(59):31-8.

Rajabnia R, Mahdavi Omran S, Majidian AR, Aghajanpour SM. Comparison of fungal flora in patients with acute otitis externa and healthy subjects. J Babol Univ Med Sci. 2010; 12(3):36-7.

Akhi M, Ahmadian A, Nejadkazem M, Ramazanzadeh R. Study on aerobic bacteria isolated from otitis externa and their sensitivity. Tabriz J Med Sci. 2001; 35(51):5-9.

Hajjartabar M. Pseudamonas aeruginosa isolated from otitis externa associated with recreational waters in some public swimming pools in Tehran Iran J Clin Infet Dise. 2010; 5(3):142-51.

Taziki MH, Bahnampour N. Causes of primary otalgia. J Gorgan Uni Med Sci. 2013; 15(3):110-3.

Sheikh MS, Qazi BY, Rameen B. Otomycosis in Khozestan Ind J Otolaryngol Head Neck Surg. 1993; 45(2):73-7.

Zarei Mahmoudabadi A, Abshirini H, Rahimi R. Fungal flora of hearing aid moulds and ear canal in hearing aid wearers in school children in Ahvaz, Iran(2008). Jundishapur J Microbiol. 2009; 2(1):22-4.

Pakshir K, Sabayan B, Javan H, Karamifar K. Mycoflora of human external auditory canal in Shiraz, southern Iran. Iran Red Crescent Med J. 2008; 10(1):27-9.

Kiakojori K, Mahdavi Omran S, Majidian AR, Ferdosi Shahandashti E, Daroonkolaii A, Rajabnia R. Comparing cerumen bacterial flora in acute otitis externa patients and healthy controls. Iran J Otorhinolaryngol. 2010; 22(60):93-6.

Kalantar E, Mosaei M, Ekrami A, Pedram M. Isolation and antimicrobial susceptibility of bacteria from external ear canal of cancer patients at Shafa Cancer Hospital- Ahvaz. J Center Res Ther. 2006; 2(1):17-9. https://doi.org/10.4103/0973-1482.19769

Mikaeili A, Nazari S. Aspergillus and otomycosis in Kermanshah, Iran. 5th Advances against Aspergillosis, 26-28 January 2012, Istanbul: Turkey, 2012.

Bauer C, Jenkins H. Otologic symptoms and syndromes. Cummings Otolaryngology: Head & Neck Surgery 6th ed Philadelphia, PA: Elsevier Saunders, 2015.

Zarei Mahmoudabadi A, Seifi Z, Gharaghani M. Lamisil, a potent alternative antifungal drug for otomycosis. Current Medical Mycology. 2015; 1(1):18-21. https://doi.org/10.18869/acadpub.cmm.1.1.18 PMid:28680976 PMCid:PMC5490317