Khảo sát một số đặc điểm dịch tễ, lâm sàng và cận lâm sàng của viêm ống tai ngoài do vi nấm tại Bệnh viện Đa khoa Sài Gòn

Abstract

Introduction: Current studies about otomycosis are mainly researched in tropical countries, while in Vietnam, the number of reports on this disease are still scanty, especially in Ho Chi Minh city. Saigon General hospital has about 120,000 outpatients per year with the rate of otomycosis about 9-10%. Objectiive: This study aims to identify fungi and its applications in diagonisis and treatment of otomycosis. Materials and methods: A descriptive study, based on the results of 69 patients with diagnosis otomycosis at Saigon Genenral hospital from 15/12/2020 to 30/06/2021. All epidemiological, clinacal and mycological information was collected. Results: Otomycosis is found in both sex (ratio of male:female is 2:1). The mean age was 44±14.87 in the range of 17-70 years old, the age group 31-60 accounted for the highest (59.42%). The occupational group of cadres, workers and employees infected with ear fungus is the highest (34.78%), followed by self-employed workers (27.54%). Ear fungus can recur easily and second recurrence is common. Men with ear fungus have a higher habit of getting earwax at home or at barbershop (59.42%) than women (24.46%); Women are more susceptible to ear fungus if they have swimming habits or occupations with water exposure (8.70%) than in men (7.25%). The clinical symptom of ear itching is the most common (79.7%), followed by tinnitus (46.38%), the third is a feeling of fullness in the ear (44.93%), the lowest is hearing loss (26.09%). Ear endoscopy: the most common one ear (79.71%), the congestive state of the outer ear canal in the outer third is the highest (43.48%), the lesions are white patches, white filaments and plaques. The most common fibers were 13.04-15.94%, and the majority of 59.42% were dry lesions. The results of microscopic examination of fungi showed that filamentous fungi accounted for the highest (68.12%), followed by yeast (17.39%) and had 2.90% negative cases. Culture results showed that one fungus strain was found with the highest strain of Aspergillus spp (69.57%), followed by Candida albicans (15.94%); The most common cases where two strains of fungi can be cultured are between A. fumigatus and C.albicans, A. niger and C.albicans, respectively, 4.35%. The Aspergillus spp is identified five types of fungi: A.fumigatus, A.niger, A.flavus, A.terreus and A.nidulans. Conclucions: Otomycosis occurs in all ages, both sexes. The risk factors increase the risk of disease: habit of getting earwax, swimming, occupation with exposure to water environment, use of hearing aids,... The results of microscopic examination of fungi are mainly images of filamentous fungi. Next is the yeast image. The results of the fungal culture were identified by the most common methods, mainly two strains of Aspergillus spp and Candida spp. During otoscopy, if we see a plaque-spherical shape of the lesion, we should think of the Candida albicans. When otoscopically, if you see white lesions with black or black dots, you should think of the A.niger. When otoscopy shows both moist and dry images or moist images of lesions, the fungus Candida albicans should be considered. Key words: otomycosis, fungi, external ear cannal