Hostname: page-component-6565fbc58-w75dz Total loading time: 0 Render date: 2026-03-13T04:51:36.847Z Has data issue: false hasContentIssue false
  • English
  • Français

Recurrent otomycosis in patients with undiagnosed diabetes mellitus: a clinical analysis

Published online by Cambridge University Press:  09 December 2025

Nishant Gill  and
Varchasvi Meena Open the ORCID record for Varchasvi Meena [Opens in a new window]
Nishant Gill
Affiliation:
Department of ENT, Government Medical College, Nagaur, India
Varchasvi Meena*
Affiliation:
Department of ENT, Jhalawar Medical College, Jhalawar, India
*
Corresponding author: Varchasvi Meena; Email: varchasvimeena@gmail.com
Get access Rights & Permissions [Opens in a new window]

Abstract

Objectives

This study aimed to determine the prevalence of undiagnosed diabetes and prediabetes in patients presenting with recurrent otomycosis and to evaluate associated risk factors, fungal profiles and cerumen pH variations.

Methods

This cross-sectional study included 213 adults with greater than or equal to two episodes of otomycosis. Glycaemic status was assessed using fasting blood sugar, post-prandial blood sugar and glycated haemoglobin. Fungal identification and cerumen pH measurement were performed. Multivariate analysis identified predictors of recurrence.

Results

Undiagnosed diabetes and prediabetes were found in 30 per cent and 13 per cent of patients, respectively. Candida albicans predominated in diabetics, while Aspergillus niger was common in normoglycaemics. Cerumen pH was significantly higher in diabetics (6.6) compared to normoglycaemics (5.3). Glycated haemoglobin greater than or equal to 6.5 per cent, Candida infection and steroid ear drop use were independent predictors of recurrence.

Conclusion

A substantial proportion of patients with recurrent otomycosis harbour unrecognised glycaemic abnormalities. Routine diabetes screening in ENT clinics may aid in early metabolic disease detection and reduce recurrence rates.

Keywords

Candida albicanscerumen pHdiabetes mellitusfungal ear infectionHbA1cotomycosis

Information

Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 140 , Issue 2 , February 2026 , pp. 177 - 182
Copyright
© The Author(s), 2025. Published by Cambridge University Press on behalf of J.L.O. (1984) LIMITED.

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

Footnotes

Varchasvi Meena takes responsibility for the integrity of the content of the paper

References

Mugliston, T, O’Donoghue, G. Otomycosis—a continuing problem. J Laryngol Otol 1985;99:327–33CrossRefGoogle ScholarPubMed
Aneja, KR, Sharma, C, Joshi, R. Fungal infection of the ear: a common problem in north India. Indian J Pathol Microbiol 2010;53:386–9Google Scholar
Mohanty, JC, Mohanty, SK, Sahoo, RC, Panda, NK. Clinicomycological profile of otomycosis in a tertiary care hospital. J Clin Diagn Res 2013;7:2466–9Google Scholar
Venugopal, P, Venugopal, TV, Palaniswamy, MS. Otomycosis: a study in Madurai. Indian J Otolaryngol 1996;2:8–10Google Scholar
Habib, HS. Otomycosis: clinical features, predisposing factors and treatment implications. Egypt J Ear Nose Throat Allied Sci 2015;16:123–6Google Scholar
Kaur, R, Mittal, N, Kakkar, M, Aggarwal, AK, Mathur, MD. Otomycosis: a clinicomycologic study. Ear Nose Throat J 2000;79:606–9CrossRefGoogle ScholarPubMed
Satish, HS, Nagaraj, MB, Kiran, K, Nandini, AS. A clinical study of otomycosis. Int J Otorhinolaryngol Head Neck Surg 2018;4:691–5Google Scholar
Bassiouny, M, El Mofty, H, Abdelrahman, M. Otomycosis: a review. J Laryngol Otol 2020;134:487–92Google Scholar
Prasad, SC, Kotigadde, S, Shekhar, M, Thada, ND, Prabhu, P, D’Souza, T, et al. Primary otomycosis in the Indian subcontinent: predisposing factors, microbiology and classification. Int J Microbiol 2014;2014:636493CrossRefGoogle ScholarPubMed
Balkis, MM, Leid, JG. Factors involved in fungal infections in diabetes mellitus. J Infect Dev Ctries 2009;3:727–36Google Scholar
Pierard, GE. Skin infections and diabetes mellitus. J Eur Acad Dermatol Venereol 1997;9:1–4Google Scholar
Alexiewicz, JM, Kumar, D, Smogorzewski, M, Klin, M, Massry, SG. Polymorphonuclear leukocytes in non-insulin-dependent diabetes mellitus: abnormalities in metabolism and function. Ann Intern Med 1995;123:919–24CrossRefGoogle ScholarPubMed
Bagdade, JD, Root, RK, Bulger, RJ. Impaired leukocyte function in patients with poorly controlled diabetes. Diabetes 1974;23:9–15CrossRefGoogle ScholarPubMed
Peleg, AY, Weerarathna, T, McCarthy, JS, Davis, TME. Common infections in diabetes: pathogenesis, management and relationship to glycaemic control. Diabetes Metab Res Rev 2007;23:3–13CrossRefGoogle ScholarPubMed
Ghosh, S, Mukherjee, P, Roy, D. Mycological and biochemical correlation in otomycosis. Indian J Otol 2016;22:157–61Google Scholar
Liu, H, Hu, C, Peng, L, Wang, Y. Immune response to fungal infection in diabetic otomycosis patients. Mycopathologia 2021;186:499–507Google Scholar
Jain, A, Jindal, M, Sharma, M. Candida otomycosis in patients with diabetes mellitus: clinical and microbiological profile. Int J Curr Microbiol App Sci 2019;8:1336–43Google Scholar
Al-Otaibi, F, Almuhanna, R, Alshareef, S. Otomycosis: a comparative study between diabetic and non-diabetic patients. Saudi Med J 2020;41:867–72Google Scholar
Seifi, Z, Shakiba, E, Rezaei-Matehkolaei, A. Molecular identification and antifungal susceptibility of clinical Aspergillus isolates from otomycosis patients. Iran J Microbiol 2018;10:287–93Google Scholar
Maheshwari, N, Rajpal, R, Gupta, V. Recurrent otomycosis: a marker of hidden diabetes mellitus. Int J Otorhinolaryngol Clin 2021;13:1–5Google Scholar
Ramli, R, Saim, L, Zainudin, MN. The prevalence of diabetes mellitus in otomycosis patients at a Malaysian tertiary centre. Malays J Med Sci 2017;24:23–8Google Scholar
Navarro-Pérez, CF, Pérez-Carro, R, Muñoz, L, Fernández-Fernández, M, López-Camarillo, C, García-Cosío, M. Clinical impact of diabetes on otomycosis recurrence. J Clin Med 2022;11:1230Google Scholar