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The microbiology of chronic middle ear effusions in children
Abstract:
Serous otitis media is the most common cause of hearing loss in childhood. Traditionally, this entity has been felt to be a sterile process. This study was undertaken to determine the incidence of infected middle ear fluid in patients with asymptomatic middle ear effusions. The external auditory canal, nasopharynx and middle ear fluids of 57 patients undergoing myringotomy were cultured. Of 57 patients, 26 had positive cultures; 67% of patients less than 36 months of age had positive culture, with a bacterial flora closely resembling that of acute otitis media. Further investigation is required to determine the significance of such infection together with the optimum therapy for chronic effusions of the middle ear in young children.
Insights
Infection may be present in middle ear fluid, even in asymptomatic cases of serous otitis media. This is particularly common in young children, suggesting a need for further investigation into treatment for chronic ear effusions.
Area of Science:
- Otolaryngology
- Pediatric Medicine
- Microbiology
Background:
- Serous otitis media is a leading cause of childhood hearing loss.
- It has traditionally been considered a non-infectious condition.
Purpose of the Study:
- To investigate the incidence of bacterial infection in middle ear fluid of children with asymptomatic otitis media with effusion.
- To characterize the bacterial flora in infected middle ear fluid.
Main Methods:
- Cultures were obtained from the external auditory canal, nasopharynx, and middle ear fluid of 57 children undergoing myringotomy.
- Patients presented with asymptomatic middle ear effusions.
Main Results:
- 26 out of 57 patients (45.6%) had positive cultures from middle ear fluid.
- In children under 36 months, 67% showed positive cultures.
- The bacterial flora in positive cultures resembled that found in acute otitis media.
Conclusions:
- Middle ear effusions in children, even when asymptomatic, may harbor bacterial infections.
- A significant proportion of young children with otitis media with effusion have infected fluid.
- Further research is needed to understand the clinical significance and optimal management of these infections.