Bacteria and endotoxin in middle ear fluid and the course of secretory otitis media

To determine the influence of bacteria and bacterial products on the course of secretory otitis media (SOM) following ventilation tube insertion we examined 68 middle ear effusions from 57 children with SOM. Swabs were taken for bacteriological examination and the content of endotoxin was measured. The children were followed up for one year and relapse of SOM was recorded. Bacteria were present in 38% of effusions and endotoxin was detectable in 96%. Relapse occurred in 26% of the patients and was related to the presence of bacteria in the original effusion (P < 0.01). The concentration of endotoxin, however, did not correlate with the course of SOM.