In recent years, an increase in the role of diseases caused by previously less etiologically significant pathogens has been noted , namely, a clear increase in fungal infection in childhood pathology. The high frequency of candidiasis in pregnant women, according to A.S. Ankirskaya, reaching 60%, is the reason for a rather massive infection of newborns during childbirth.
G. A. Samsygina points out that along with the mucous membranes and skin, the gastrointestinal tract serves as the entry gate for candida with the formation of generalized candidiasis or central nervous system candidiasis. Moreover, generalized candidiasis increased from 1.9% of cases in 1975 to 15.1% in 1995.
According to V. B. Antonov , an increase in the incidence of visceral mycoses all over the world is accompanied by the formation of especially virulent strains of pathogens, causing not only sporadic diseases, but also massive outbreaks in high-risk groups with a severe course and a fatal outcome. With the development of mycosis under the influence of environmental and iatrogenic causes, a stepwise deepening of immunodeficiency occurs, which predetermines further chronicity of the process and a sequential increase in relapse. The author defines mycoses as diseases of progress and civilization.
Fungal flora is essential for recurrent and chronic external and middle otitis media. This problem was especially acute after the accident at the Chernobyl nuclear power plant, when a large number of children with disseminated and generalized forms of mycoses appeared.
Children of a young age are the largest group of risk of fungal infection, particularly Candida. It can occur in acute and chronic form, be a local process, as well as systemic, visceral, generalized and proceed especially hard.
G. N. Buslaev et al. established the frequency of candidiasis, which ranges from 30-40% among children transferred to the neonatal pathology department. In this case, the diagnosis of candidiasis in the direction of the maternity ward is practically not found.
The increasing role of fungi in the pathology of ENT organs causes new problems in connection with the development of an atypical clinical picture with a specific course and an increase in the percentage of complicated forms of pathology.
To date , many issues of treatment and prevention remain unresolved. There are problems of late diagnosis. Pathogenetic treatment in these cases is difficult, since the cause of the disease remains unrecognized for a long time. There is no adequate treatment, taking into account the age characteristics of the child’s body.
The term ” otomycosis ” currently means a fungal disease of the external auditory canal, other parts of the ear, as well as mycosis of the cavities after surgery on the ear (Kunelskaya V. Ya.).
For the first time this disease was described in the middle of the XIX century, in 1844, by the German doctor Mayer. In an 8-year-old girl, a fungus was isolated from a pathological detachable external auditory canal. The second description belongs to the Italian explorer Pacini. Moreover, judging by the description, in both cases there was a fungus of the genus Aspergillus. Then more and more often isolated reports of observations of otomycoses began to appear (Cramer H., Wreden R. R., Hagen R., Bezold F., Politzer A.). A more complete description of this disease, new for that time, was given in the works of R. R. Wreden in 1867 and in the work of F. Siebenmann.
Russian doctor R. R. Vreden analyzed 14 cases of clinical observations. The causative agents in 10 cases were fungi of the genus Aspergillus. Therefore, mycotic ear disease was called “aspergillus myringomycosis.” In a monograph by F. Siebenmann on mold mycoses of the ear, 27 clinical observations are analyzed. The causative agents were also fungi of the genus Aspergillus. In Russia, in addition to R.R. Vreden, V.P. Ilyin was involved in the studies of otomycosis. Given that in the first studies on otomycosis there was no clear data on the microbiological characteristics of the pathogen, this disease in countries with a temperate climate was unreasonably forgotten.
In addition, works began to appear from countries with a tropical and subtropical climate, in which the idea was expressed of the direct influence of such factors as a hot climate on the introduction of pathogenic fungi into the outer ear of a person. W. K. Hatch and R. Rou in 1900 recorded 22 cases of otomycosis in 1 month at the Bombay hospital. M. Langeron led a clinical observation of fungal otitis media in Brazil. A.M. Dunlap described several cases of otomycosis in China.
At the same time , a large number of works by other authors appear, which, studying otomycosis, concluded that increased incidence is observed in countries with hot climates (Bristow WJ, Reeh M. J., Davis, Coghlan C. ZM, Basil-Jones B. M, Lurie H.). In order to emphasize the connection of otomycosis with a hot climate, the authors gave the disease new names: “tropical ear”, “Singapore ear”, “tropical otomycosis”, etc. Based on these clinical observations, they began to believe that otomycosis occurs exclusively in tropical countries. and other descriptions of otomycosis began to be skeptical.
Only in the 30-40s of our century in Europe again there were cases of a single disease of otomycosis (Motta, Cjill, Ms Burnney, Seaney, Braun, etc.). In all the cases described, the causative agents were fungi of the genus Aspergillus with localization of the process in the area of the external auditory canal. These scientific reports were an incentive for clinicians to a deeper study of the disease (Polyansky L.N., Shea, Brailovsky Y. Z.).
In the 60-70s of the XX century, in connection with new scientific developments in the field of mycological research, as well as the unreasonable active use of antibiotics, a significant number of works appeared based on dozens of observations (Kunelskaya V. Ya., Lvova S. V., Arya , Mohopatra, Cojocarn et al. Ms. Gill). The first reports of mycotic complications of postoperative cavities after radical surgery on the ear appeared (Preobrazhensky N. A., Cavados, Fendell, Lumsden).
The most complete description of mycotic lesions of cavities after radical operations on the middle ear in his work “Fungal diseases of the postoperative cavity of the middle ear” is given by N. A. Lev. Having examined 40 patients, the author came to the conclusion that along with the specific clinic characteristic of fungal lesions, fungal diseases of the postoperative middle ear cavity can be observed. The clinical picture of this disease has much in common with non-epidermal cavity of another etiology. Callahan et al. believe that surgical failure during surgery on the ear is often due to a fungal infection not detected before surgery.