As increasing numbers of antibiotics, adrenocorticosteroids, and antitumor agents have come into use, so increasing numbers of mycotic diseases have been identified. Otomycosis, a mycotic infection of the external ear which is occasionally accompa nied by dermatitis of the surrounding skin, is considered to be such a disease. W-hile opinion varies as to whether otomycosis is caused by a saprophytic or a pathogenic organism, our clinical observations revealed pathological inflammation of the external auditory canal with profuse fungal elements.
During August 1975, 13 specimens of ear wax were taken from patients who vi-sited the out-patient ENT clinic of this hospital. All patients had had their ears cleaned at a barber shop prior to visiting the ENT clinic. Because ear cleaning instruments (scoops and brushes) are re-used in Korean barber shops, 204 of these instruments were randomly selected from different barber shops and examined. KOH mounts and Lactophenol Cotten blue stains were used to examine the specimens.
Of the 13 ear wax specimens, 12 samples (92.3%) revealed Aspergillus sp. and 1 sample (7.7%) revealed Penicillium sp. Of the 204 ear cleaning instruments tested,. 194 colonies grew in culture. Of these cultures, 146 (75.3%) were Aspergillus sp., 9 (4.6 %) were Mycelia sterila, 5 (2.6 %) were Penicillium sp., 4 (2.1 %) were Alternaria, 2 (1.0 %) were Stemphylium sp., 1 (0. 5 %) was Geotrichum sp., and 27 (13.9%) were of an unknown species. Of the 146 Aspergillius sp. cultures, 99 (67.8%) were Asp. terreus, 17 (11.6%) were Asp. glaucus, 5 (3.4%) were Asp. niger,. 17 (11.6 %) were Asp. flavus-oryzae, 3 (2.1%) were Asp. versicolor, and 5 (3.4 % ) were others.
Because of the close correlation between the fungi cultivated from ear wax specimens and those cultured from ear cleaning instruments, the authors believe that the ear cleaning instruments used in the barber shops could well have been the primary source of infection. In this study the authors also discuss the probable causative factors of otomycosis and a review of the literature is presented.
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