摘要
背景：耳黴菌症在亞熱帶的台灣，是一種罕見的疾病。本研究對於台南地區疑似耳黴菌症病患，進行黴菌菌種鑑定，並探討臨床症狀及耳黴菌症之間關係，以供臨床治療上之參考。 方法：自1996年9月至1998年2月間，本科的門診病人中，疑似耳黴菌症的患者190名及局部檢查正常（無菌絲物及不正常耳垢）且無臨床症狀者39名，採集其耳道內容物作微生物培養。並進一步探討病人中有明顯症狀而局部檢查正常者，耳黴菌之檢出率及菌相，並與局部檢查正常且無臨床症狀者分析比較。 結果：疑似耳黴菌症的患者黴菌檢出率為80％，主要致病菌種為土麴菌（Aspergillus terreus），佔50.2％，黃麴菌次之（12％），其臨床症狀以耳癢（86％）為主。疑似耳黴菌症的患者中，有明顯症狀而耳道局部鏡檢正常者，黴菌檢出率為43.2％。而局部檢查正常且無症狀之對照組，黴菌檢出率為44.0％，兩者之菌相並不同，其中前者仍以土麴菌為主（17.9％），後者則以菌絲體（Mycelia sterialia）佔多數（20％）。 結論：台南地區檢出耳黴菌症之菌種以土麴菌為主。耳黴菌症大多數依耳道局部鏡檢即可診斷出來。然而臨床症狀明顯但局部檢查正常之患者，是否真為耳黴菌症，則有賴黴菌培養，才能進一步診斷。
並列摘要
Background: Otomycosis is a common disease in subtropical arease including Taiwan. In the present study, we attempted to identify the species of fungus in patients suspected to have otomycosis. Methods: This study included 190 patients with suspected otomycosis and 39 healthy individuals. It was conducted in the Department of Otolaryngology at Provincial Tainan Hospital through September 1996 to February 1998. Cerumen or crust collected from patients and patients and healthy individuals were sent for culture. The results of these groups were compared with each other. Results: Positive cultures were found in 80% of patients with possible otomycosis. The predominant species was Aspergillus terreus (50.2%), followed by Aspergillus flavus (12.0%). The major symptom was itching of the ear (86%). However, positive fungus cultures were detected in 43.2% of patients with only itching symptoms and 44.0% of healthy individuals. The major fungal species isolated was Aspergillus terreus (17.9%) in the former group and Mycelia sterialia (20%) in the latter group. Conclusions: The predominant species of fungus present in patients with otomycosis in Tainan was Aspergillus terreus. Most of the patients with otomycosis could be diagnosed by otoscopic examination. In patients with itching symptoms only, fungus culture of the ear canal is recommended to make final diagnosis.