Does fungal infection is the main Journal Reading

cause for persistent middle ear

otorrhea?
Hazama Mohamad, Mohd Khairi Md Daud, Habsah Hasan, Wong Chun Yiing

M. Naufal Atsiilah
Nadila Zatiah Zahrah
Nita Lestari
Nurul Izzah Aulia
Raihan Maulida

CLINICAL CLERKSHIP OF OTORHINOLARYNGOLOGY DEPARTMENT

FACULTY OF MEDICINE OF RIAU UNIVERSITY
ARIFIN ACHMAD GENERAL HOSPITAL
2022
 What’s Our Topic?
01 Abstract

02 Introduction

03 Material and Method

04 Result

05 Discussion
2

06 Conclusion
Abstract

Objectives Method

Result Conclusion

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1 INTRODUCTION
 Chronic Suppurative Otitis Media (CSOM)

1-46 %
Highest in Alaska,
Canada, Greenland
Malaysia : 2%
school children

Incidence : developing countries >> 5

 • Pseudomonas
aeruginosa (18%-
Most common cause 67%)
• Staphylococcus
aureus (14%-33%)
Fungus was through to
play part in CSOM
The aim of this study

“To look at the

involvement of fungus in
CSOM with persistent
otorrhea”

Candida albicans Aspergillus

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 MATERIAL AND
2 METHODS
 MATERIAL AND METHODS
Study Design Location
Cross Sectional Study Otorhinolaryngology (ORL)
clinic in a tertiary hospital

Inclusion Criteria Exclusion Criteria

CSOM with persistent • Otomycosis

ear discharge for ≥2 • Intact tympanic
weeks membrane
• Otitis externa
• Cholesteatoma

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 Method
Sent for fungal culture and
• Samples were collected  bacteria microscopic
examination

After examination :

Yes Repeat fungal

Ofloxacin for 2 Persistent discharge
culture & bacteria
weeks

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RESULT
 About 52% of patients were below 20 years
old with peak incidence in age group of 1–10
years old.

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DISCUSSION
• Age group 1-10 years old  Repeated upper respiratory tract
infection & Eustachian dysfunction (Khanna et al)

• Female (67,7%) : Male (32,3%)  it was contrast due to the

increase of health awareness in women population (Khanna et
al. and Obi et al)

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• Incidence of positive fungal culture in persistent
middle ear otorrhea were only 5.0% 
Received better health/medical advice, and
antibiotic era
• the incidence of fungal infection in many of
other studies were higher compared to our
study  the method use in obtaining sample
• After the intervention, otorrhea was still
present in 16 (25.8%) patients  required 21
days to achieve clinical cure (Aslan et al) or it
caused by resistant organisms.
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• secondary fungal infection due to prolong usage of
quinolone ear drops.  pH of 7 provides a moist and
alkaline environment
• persistent otorrhea and not respond to topical ab

Culture study
History taking, PE, Diagnose
Culture

Fungi Resistant
microorganism 16
 Conclusion
• The incident of fungal colonization in
persistent otorrhea is low (5%).
• Bacteria are still the most common
microorganism in persistent
otorrhea.
• The unresolving ear discharge may
be due to the improper ear care by
the patients.
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“
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