Exploring the Incidence of Otomycosis in Immunocompetent and Immunocompromised Individuals

Objective: This study aims to evaluate the incidence, clinical presentation, mycological profile, and treatment outcomes of otomycosis in immunocompetent versus immunocompromised individuals. Methods: This prospective cohort study was conducted over one year and included 300 randomly selected patients with ear complaints, divided equally into immunocompetent and immunocompromised groups. Diagnosis was confirmed via KOH mount and culture on Sabouraud’s Dextrose Agar. Treatment involved aural toileting and topical antifungal therapy, starting with Clotrimazole and escalating to Fluconazole if needed. Results: Otomycosis was diagnosed in 101 patients: 26% in the immunocompetent group and 41.3% in the immunocompromised group, showing statistical significance (p=0.0070). Males were more affected in both groups. Aspergillus Niger was most common in immunocompetent, while Candida species dominated in immunocompromised patients. Recovery time was shorter in immunocompetent patients (10±3.5 d) compared to immunocompromised ones (16±4.2 d), with 35.4% requiring Fluconazole. Conclusion: Otomycosis is more prevalent and tougher to manage in immunocompromised individuals, with Candida species as the leading pathogen. Tailored treatment, including timely escalation from Clotrimazoleto Fluconazole, is essential in these patients.