Various topical antifungal agents in otomycosis, which is the best?

OBJECTIVE: To assess the effectiveness of some topical non-specific antifungal agents compared to topical specific antifungal drugs in otomycosis therapy. METHODS: The single-blind comparative prospective study was conducted from January 1, 2018, to January 1, 2019, at the outpatient department of Al Yarmouk Teaching Hospital, Baghdad, Iraq, and comprised patients presenting with signs and symptoms of otomycosis. The clinical diagnosis was made using otomicroscopy and was confirmed by ear swab results. They were classified into 3 equal groups, with group A receiving 1% clotrimazole ear drops, group B 3% salicylic acid drops, and group C 10% povidone iodine drops. Treatment in all the groups lasted three weeks. Data was analysed using SPSS 20. RESULTS: Of the 120 patients, 40(33.3%) were in each of the three groups. Overall, there were 62(51.6%) males and 58(48.4%) females with a mean age of 30.79±7.82 years. The left ear was affected in 70(58.33%) patients, and the right ear in 50(41.66%). The most commonly detected symptom was itching in 102(85%) patients. The type of fungus detected was aspergillus niger in 67(55.84%) patients and candida albicans in 53(44.16%). The overall response to treatment was in 90(74.99%) patients; group A 39(97.5%), group B 29(72.5%), and group C 21(52.5%) (p=0.0001). CONCLUSIONS: Local antifungal agents clotrimazole, 3% salicylic acid and 10% povidone iodine were effective in the treatment of otomycosis with varying degrees of success, with clotrimazole being the most effective.

Pott's puffy tumour of the frontal and Parietal bones with subgaleal abscess as a complication of acute sinusitis - a case report.

Acute sinusitis is a frequent medical condition that can affect any age group and may lead infrequently to very serious life-threatening complications. These complications include the spread of infection to frontal and other cranial bones, meninges, and other intracranial structures that require urgent medical actions to prevent mortality and morbidity. We report the case of acute frontal sinusitis in a 14 years old male who presented with fever, severe headache, and fluctuant swelling of the nasal root, and right supraorbital and frontoparietal regions. Imaging studies demonstrated signs of left-sided sinusitis, osteomyelitis of the frontal bones, and right parietal bone. Urgent surgery was performed with drainage of the abscesses and samples were sent for culture and sensitivity. Bilateral antral washout and trephination of the left frontal sinus was performed and pus was evacuated. Growth of Staphylococcus aureus and Peptostreptococcus micros was reported and according to the sensitivity report, the patient was kept on intravenous meropenem, 1500 mg per day and vancomycin 1500 mg per day was added on the 7th postoperative day. The patient was discharged from the hospital in good health on the 25th postoperative day and kept on oral vancomycin for one month.