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Otomycosis Due to the Rare Fungi Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum

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Abstract

Otomycosis is a common finding in otorhinolaryngology clinics and is usually caused by species of Candida and Aspergillus, particularly black aspergilli. Meanwhile, other fungi can give rise to this infection, and the identification of these requires accurate methods. Here, we report three cases of otomycosis due to rare fungal pathogens. All the patients were young females, and manipulation of the ear canal was identified as a common potentially predisposing factor. In direct examination, filamentous fungal elements (in one case) and yeast cells (in two other cases) were seen. Culture was positive in all cases. Based on PCR-sequencing of internal transcribed spacers and β-tubulin (for mold isolate), the isolated fungi were identified as Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. By susceptibility testing of the isolates to fluconazole, itraconazole, voriconazole and amphotericin B, the lowest minimum inhibitory concentration values were observed for amphotericin B followed by voriconazole. Patients were successfully treated by a combination of antifungals and corticosteroids with no relapse over the next year, except for the case due to F. magnum, in which, despite partial recovery, a course of relapse was reported in the 1-year follow-up call.

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Funding

The funding was provided by Isfahan University of Medical Sciences, Isfahan, Iran (Grant No. 396223).

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Authors and Affiliations

  1. Department of Medical Parasitology and Mycology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran

    Shima Aboutalebian & Hossein Mirhendi

  2. Department of Medical Parasitology and Mycology, School of Medicine, Iran University of Medical Sciences, Tehran, Iran

    Shahram Mahmoudi

  3. Department of Otolaryngology, Isfahan University of Medical Sciences, Isfahan, Iran

    Ahmadreza Okhovat

  4. Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran

    Sadegh Khodavaisy

Authors
  1. Shima Aboutalebian
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  2. Shahram Mahmoudi
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  3. Ahmadreza Okhovat
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  4. Sadegh Khodavaisy
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  5. Hossein Mirhendi
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Corresponding author

Correspondence to Hossein Mirhendi.

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The authors confirm that all the data and figures in this article are original and have not been published elsewhere. All the authors contributed sufficiently to the work and have approved the final version of the manuscript.

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Informed consent was obtained from all cases prior to publishing their data. Furthermore, the authors confirm that the checklist for submission of a case report to Mycopathologia published by Bouchara et al. [29] has been followed and completed.

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Aboutalebian, S., Mahmoudi, S., Okhovat, A. et al. Otomycosis Due to the Rare Fungi Talaromyces purpurogenus, Naganishia albida and Filobasidium magnum. Mycopathologia 185, 569–575 (2020). https://doi.org/10.1007/s11046-020-00439-8

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  • DOI: https://doi.org/10.1007/s11046-020-00439-8

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