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Otitis media with effusion associated with Chlamydia trachomatis infection in children
K Hashiguchi1, H Ogawa, K Koga
1Department of Otolaryngology, University of Occupational and Environmental Health, Kitakyushu, Japan.
Abstract:
In an attempt to discover the role of Chlamydia trachomatis in the pathogenesis of middle ear diseases, we examined middle ear effusions (MEEs) from 69 patients with otitis media with effusion (OME) for the presence of C. trachomatis and antibodies to the organism. Age distribution was 1 to 14 years (mean age 6.1 years). C. trachomatis was isolated by the culture method from MEE of 11 of 31 (35.5%) patients and from 2 of 5 (40.0%) nasopharyngeal specimens. Chlamydial antigen, however, was found in 29 MEEs from 57 patients (50.9%) using an immunofluorescent method (Syva, 'MicroTrak'). Antibodies to the agent were found in 23 MEEs of 40 patients (57.5%) using the Micro-IF test. Antigen and antibodies were determined at the same time and both were detected in 20 of 40 (50.0%) patients. Although the isolation rate for C. trachomatis from MEE was low, antigen and antibodies were detected in 50.0% of patients with OME. These results suggest the possibility that immune complexes are formed with C. trachomatis in the middle ear, and that these immune complexes cause the mucosal damage responsible for chronic middle ear mucosal irritation.
Insights
Chlamydia trachomatis may play a role in middle ear diseases. The study found evidence of the bacteria and immune responses in children with otitis media with effusion, suggesting immune complex formation.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Immunology
Background:
- Otitis media with effusion (OME) is a common pediatric condition.
- The role of specific pathogens, like Chlamydia trachomatis, in OME pathogenesis requires further investigation.
Purpose of the Study:
- To investigate the presence and role of Chlamydia trachomatis in the pathogenesis of middle ear diseases.
- To determine the prevalence of C. trachomatis and antibodies in middle ear effusions (MEEs) of patients with OME.
Main Methods:
- Analysis of MEEs and nasopharyngeal specimens from 69 pediatric OME patients.
- C. trachomatis isolation via culture.
- Detection of chlamydial antigen using immunofluorescence (Syva 'MicroTrak').
- Detection of antibodies to C. trachomatis using Micro-IF test.
Main Results:
- C. trachomatis was isolated from 35.5% of MEE cultures.
- Chlamydial antigen was detected in 50.9% of MEEs.
- Antibodies to C. trachomatis were found in 57.5% of MEEs.
- Both antigen and antibodies were detected in 50.0% of patients.
Conclusions:
- Despite low culture isolation rates, antigen and antibodies suggest C. trachomatis involvement in OME.
- Immune complexes formed with C. trachomatis in the middle ear may cause mucosal damage.
- This supports a potential role for C. trachomatis in chronic middle ear irritation.