Immune Complexes in Middle Ear Fluid in Chronic Secretory Otitis Media

1983 ◽  
Vol 92 (1) ◽  
pp. 42-44 ◽  
Author(s):  
Tauno Palva ◽  
Tessa Lehtinen ◽  
Juhani Rinne
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Immune Complexes ◽  
Complex Disease ◽  
Capsular Polysaccharide ◽  
Immune Complex Disease ◽  
Secretory Otitis Media ◽  
Opportunistic Bacteria ◽  
Middle Ear Fluid

Data on 87 patients (113 ears) with chronic secretory otitis media (SOM) are reported. The bacteriological analysis of the middle ear fluid (MEF) revealed Streptococcus pneumoniae in 7% of ears, Hemophilus influenzae in 9%, opportunistic bacteria in 20%, while 64% of the samples showed no growth. Free capsular polysaccharide pneumococcal antigens were found in 5 % of the MEF samples using counterimmunoelectrophoresis (CIEP) with Omniserum containing 83 different pneumococcal polysaccharide types. Heating of the samples to disrupt the immune complexes increased the frequency of positive samples to 27%. These findings, together with the frequent occurrence of S pneumoniae and H influenzae in the nasopharynx, strongly support the opinion that chronic SOM in a considerable number of cases is an immune complex disease.

Air Conduction Thresholds and Secretory Otitis Media: A Conventional and Extra-High Frequency Audiometric Comparison

1989 ◽  
Vol 98 (10) ◽  
pp. 767-771 ◽  
Author(s):  
Iain W. S. Mair ◽  
Oddbjørn Fjermedal ◽  
Einar Laukli
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
High Frequency ◽  
Pure Tone ◽  
Low Frequency ◽  
Secretory Otitis Media ◽  
Middle Ear Fluid ◽  
Ventilation Tubes ◽  
Air Conduction

A comparison has been made of air conduction threshold changes up to 1 year after myringotomy, aspiration of middle ear fluid, and insertion of ventilation tubes in ten patients with bilateral and 12 with unilateral secretory otitis media (SOM). Pure tone air conduction thresholds have been analyzed in three frequency groups: Low frequency (LF; 0.25, 0.5, and 1 kHz), high frequency (HF; 2,4, and 8 kHz), and extra-high frequency (EHF; 10, 12, 14, and 16 kHz). In the LF and HF ranges, significant improvement came during the first 24 hours after intubation, while in the EHF range, threshold lowering occurred gradually over the following 2 months. Possible explanations for these findings are discussed.

Acute Suppurative Otitis Media

PEDIATRICS ◽  
1975 ◽  
Vol 56 (2) ◽  
pp. 285-294
Author(s):  
D. Stewart Rowe
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Pathogenic Bacteria ◽  
Acute Otitis Media ◽  
Polymorphonuclear Cells ◽  
Secretory Otitis Media ◽  
Middle Ear Mucosa ◽  
Suppurative Otitis Media ◽  
Middle Ear Fluid ◽  
Purulent Fluid

Most pediatricians recognize and treat acute otitis media several times each day. Yet there is wide disagreement about certain aspects of its diagnosis and treatment, despite a large and growing literature on the subject. This review attempts to summarize what is known about acute otitis media in children. DEFINITION Acute suppurative otitis media is distinguished from secretory (serous) otitis media by the presence of purulent fluid in the middle ear. Pathogenic bacteria may be cultured from the majority of needle aspirates of this purulent fluid. In secretory otitis media, relatively few polymorphonuclear cells are present in the middle ear fluid, which is either thin and straw-colored (serous) or thick and translucent grey (mucoid). The fluid has the chemical characteristics either of a transudate of plasma or of a mucoid secretion, presumably produced by goblet cells and mucous glands which are greatly increased in the middle ear mucosa of patients with secretory otitis media. Cultures of this middle ear fluid are usually negative for pathogenic bacteria and viruses. Suppurative otitis media can be diagnosed positively only by aspiration of purulent fluid from the middle ear, but this procedure is rarely necessary for initial diagnosis and management. Clinical findings helpful in distinguishing suppurative from secretory otitis media are discussed below. INCIDENCE In a study of 847 British children during the first five years of life, 19% had at least one episode of otitis media; one third of these had more than one episode. This was considered to be a minimal estimate in these children, since otorrhea was the chief criterion for diagnosis.

MIDDLE-EAR FLUID STREPTOCOCCUS PNEUMONIAE SUSCEPTIBILITY AND SEROTYPE AND DISTRIBUTION IN MEXICAN CHILDREN WITH ACUTE OTITIS MEDIA

PEDIATRICS ◽  
2008 ◽  
Vol 121 (Supplement 2) ◽  
pp. S129.2-S129 ◽  
Author(s):  
Claudia Lopez-Enriquez ◽  
A. Blanco-Montero ◽  
L. E. Espinosa-Monteros ◽  
R. Rodriguez ◽  
C. De La Torre ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Mexican Children ◽  
Middle Ear Fluid

scholarly journals Streptococcus pneumoniae Isolates from Middle Ear Fluid and Nasopharynx of Children with Acute Otitis Media Exhibit Phase Variation

2011 ◽  
Vol 49 (4) ◽  
pp. 1646-1649 ◽  
Author(s):  
J. Arai ◽  
M. Hotomi ◽  
S. K. Hollingshead ◽  
Y. Ueno ◽  
D. E. Briles ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Phase Variation ◽  
Middle Ear Fluid

Spray bacteriotherapy decreases middle ear fluid in children with secretory otitis media

2008 ◽  
Vol 94 (2) ◽  
pp. 92-98 ◽  
Author(s):  
S Skovbjerg ◽  
K Roos ◽  
S E Holm ◽  
E Grahn Hakansson ◽  
F Nowrouzian ◽  
...  
Keyword(s):  
Otitis Media ◽  
Middle Ear ◽  
Secretory Otitis Media ◽  
Middle Ear Fluid

scholarly journals Efficacy of Solithromycin (CEM-101) for Experimental Otitis Media Caused by Nontypeable Haemophilus influenzae and Streptococcus pneumoniae

2016 ◽  
Vol 60 (9) ◽  
pp. 5533-5538 ◽  
Author(s):  
M. Figueira ◽  
P. Fernandes ◽  
S. I. Pelton
Keyword(s):  
Streptococcus Pneumoniae ◽  
Haemophilus Influenzae ◽  
Otitis Media ◽  
Middle Ear ◽  
Fourth Generation ◽  
Minimal Bactericidal Concentration ◽  
Nontypeable Haemophilus Influenzae ◽  
Time Curve ◽  
Content Type ◽  
Middle Ear Fluid

ABSTRACTSolithromycin (CEM-101) is a “fourth-generation” macrolide, as it has three binding site and is acid stable. The three binding sites confer activity against bacteria resistant to the older macrolides and ketolides, including multidrug-resistantStreptococcus pneumoniaeand nontypeableHaemophilus influenzae(NTHi). The objective of this study was to evaluate solithromycin pharmacokinetics (PK), middle ear fluid (MEF) concentrations, and microbiologic efficacy in a chinchilla model of experimental otitis media (EOM) due to strains ofS. pneumoniaeor NTHi. Plasma PK (maximum concentration of drug in serum [Cmax] and area under the concentration-time curve from 0 to 24 h [AUC0–24]) and middle ear fluid (MEF) concentrations were determined. Isolates with specified antimicrobial susceptibility patterns were inoculated directly into the middle ear (ME). Plasma and MEF were collected for PK and MEF cultures performed to determine efficacy. Solithromycin administered at 150 mg/kg of body weight/day resulted inCmaxand AUC0–24values of 2.2 μg/ml and 27.4 μg · h/ml in plasma and 1.7 μg/ml and 28.2 μg · h/ml in extracellular MEF on day 1. By day 3,Cmaxand AUC0–24values had increased to 4.5 μg/ml and 54 μg · h/ml in plasma and 4.8 μg/ml and 98.6 μg · h/ml in extracellular MEF. For NTHi EOM, three isolates with MIC/minimal bactericidal concentration (MBC) ratios of 0.5/1 μg/ml (isolate BCH1), 2/2 μg/ml (isolate BMC1247C), and 4/4 μg/ml (isolate BMC1213C) were selected. The MEF of >85% of animals infected with BCH1 and BMC1247C was sterilized. For NTHi BMC1213, >85% of MEF cultures remained positive. ForS. pneumoniaeEOM, 3 isolates with MIC/MBC ratios of 0.06/0.125 μg/ml (S. pneumoniae331), 0.125/1 μg/ml (S. pneumoniaeCP-645 [MLSBphenotype]), and 0.5/2 μg/ml (CP-712 [mefAsubclassmefAresistance]) were selected. Solithromycin sterilized MEF in 100% of animals infected withS. pneumoniae331 andS. pneumoniaeCP-645. ME infection persisted in 60% of animals infected with CP-712. In a model of EOM, solithromycin sterilized MEF in >85% of animals challenged with NTHi with an MIC of ≤2 μg/ml and 100% of ME infected withS. pneumoniaewith an MIC of ≤0.125 μg/ml.

scholarly journals Characterization and Dynamics of Middle Ear Fluid and Nasopharyngeal Isolates of Streptococcus pneumoniae from 12 Children Treated with Levofloxacin

2007 ◽  
Vol 52 (1) ◽  
pp. 378-381 ◽  
Author(s):  
Todd A. Davies ◽  
Eugene Leibovitz ◽  
Gary J. Noel ◽  
David F. McNeeley ◽  
Karen Bush ◽  
...  
Keyword(s):  
Streptococcus Pneumoniae ◽  
Otitis Media ◽  
Middle Ear ◽  
Acute Otitis Media ◽  
Middle Ear Fluid

ABSTRACT Children who had acute otitis media and were treated with levofloxacin were assessed for the emergence of fluoroquinolone-resistant Streptococcus pneumoniae. Nasopharynx cultures were obtained from patients at the entry to and during levofloxacin therapy. All nasopharynx isolates (n = 59) from 12 children were levofloxacin susceptible without parC/E or gyrA/B mutations. Pneumococcal nasopharynx persistence was not associated with levofloxacin resistance.

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