Challenges and future strategies for management of otomycosis caused by Fusarium species: A systematic review and meta-analysis
نویسندگان
1 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
2 Department of Visceral, Transplant and Thoracic Surgery, Medical University of Innsbruck, Innsbruck, Austria
3 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
4 Molecular Medicine Research Center, Hormozgan Health Institute, Hormozgan University of Medical Sciences, Bandar Abbas, Iran
5 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
6 Department of Food Science and Technology, Damghan Branch, Islamic Azad University, Damghan, Islamic Republic of Iran.
7 Department of Molecular Microbiology & Immunology, South Texas Center for Emerging Infectious Diseases, The University of Texas at San Antonio, San Antonio, TX 78249, USA
8 Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa 616, Oman Center of Expertise in Mycology, Radboud University Medical Center/Canisius Wilhelmina Hospital,6532 SZ Nijmegen, The Netherlands
9 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
10 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
11 Department of Medical Mycology and Parasitology, School of Medicine, Babol University of Medical Sciences, Babol, Iran
12 Invasive Fungi Research Center, Communicable Diseases Institute, Mazandaran University of Medical Sciences, Sari, Iran Department of Medical Mycology, School of Medicine, Mazandaran University of Medical Sciences, Sari, Iran
13 Department of Medical Parasitology and Mycology, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran.
14 Department of Medical Parasitology and Mycology, School of Medicine, Jahrom University of Medical Sciences, Jahrom, Iran
15 Department of Laboratory Sciences, Sirjan School of Medical Sciences, Sirjan, Iran
16 Medical Faculty, University of Niš, 18000 Niš, Serbia Public Health Institute Niš, 18000 Niš, Serbia.
doi
10.22034/cmm.2025.345494.1722چکیده
Background and Purpose: Otomycosis caused by Fusarium species has been increasingly documented in recent years. This study aimed at an overview of clinical presentations, diagnostic methods, treatment alternatives, epidemiology, and future management strategies for this infection.Materials and Methods: A literature search was conducted in five scientific databases from 1966 to July 2023. The keywords included "Fusarium", "fusariosis", "otomycosis", "otitis externa", "ear disorder", and "ear infection". After title and abstract screening, 354 papers advanced to full-text screening; subsequently, 343 were excluded as non-relevant or case reports, leaving 11 studies to be included in this review.Results: Fusarium otomycosis primarily occurs in healthy individuals, particularly those with diabetes or a history of trauma or ear infections. Clinical symptoms include pruritus, pain, otorrhea, hearing loss, and external ear canal inflammation. Diagnosis mainly uses conventional methods, though molecular techniques offer accurate species identification. Treatment is challenging due to resistance to traditional antifungals; however, topical agents, like terbinafine, voriconazole, amphotericin B, and natamycin, show promise in management. In this review, the pooled prevalence of otomycosis due to Fusarium species is estimated at 2.3 (95% CI= 1.2-3.7).Conclusion: The findings indicated that otomycosis caused by Fusarium species is an emerging clinical entity that warrants attention. Considering the resistance of Fusarium species to most currently available antifungal drug classes, physician awareness and proper diagnostic techniques are essential for timely diagnosis, accurate identification, and appropriate management of this infection.
