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1/4. Clinical characteristics of so called eosinophilic otitis media.

    OBJECTIVE: Although "eosinophilic otitis media" is not as uncommon a condition as was previously believed, its cause and pathogenesis are not yet fully understood. The purpose of this study was to describe the clinical characteristics in patients with "eosinophilic otitis media" to clarify its pathogenesis. methods: Seven adult patients with persistent and intractable otitis media with viscous middle ear effusion containing many eosinophils, who were also under treatment for bronchial asthma, were studied. The following examinations were conducted: nasopharyngeal endoscopy, pure-tone audiometry, eustachian tube function test, temporal bone CT scan, blood analysis, bacterial and fungal culture of middle ear effusion, histological study of the middle ear and nasal specimens, and measurement of eosinophilic cationic protein (ECP) in middle ear effusion. RESULTS: Some patients had persistent perforation with papillomatous granulation tissue arising from the mesotympanic mucosa, and all the patients had nasal polyposis. The pure-tone audiometry showed the mixed-type of hearing loss in all the patients, and the hearing level deteriorated progressively during the course in some patients. The eustachian tube function was not always poor but was patulous in some cases. The most severely diseased areas were in the eustachian tube and mesotympanum by temporal bone CT images. All the seven patients had the high levels of total serum IgE, but the RAST scores were negative in three patients and low grade in three patients. The accumulation of eosinophils was observed in middle ear effusion, middle ear mucosa and nasal polyps, and the eosinophils were highly activated with degranulation. High level of ECP was also recovered from middle ear effusion. CONCLUSIONS: Active eosinophilic inflammation occurs in the entire respiratory tract, including the middle ear in these patients. From our present investigation, we propose the criteria and clinical characteristics of "eosinophilic otitis media".
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ranking = 1
keywords = culture
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2/4. bordetella pertussis causing otitis media: a case report.

    OBJECTIVE/HYPOTHESIS: is an unusual cause of otitis media with effusion. We report a case in a neonate. STUDY DESIGN: Case report. methods: A case is presented. RESULTS: A 1-month-old infant girl was admitted because of respiratory distress and subsequently was found to have pertussis. On examination she was noted to have a middle ear effusion. Myringotomy was performed for culture. culture confirmed. We were unable to find a previous report of otitis media. CONCLUSION: has been identified in the middle ear effusion of an infant with the pertussis syndrome.
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keywords = culture
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3/4. enterococcus faecalis and otitis media with effusion. How to treat.

    Although microorganisms are cultured in only one out of 3 middle ear effusions, viable and non-viable bacteria are presumed to be responsible in part for otitis media with effusion (OME). Because of this association, antibiotics in sublethal, bacteriostatic, or bacteriocidal concentrations are frequently used as non-surgical therapy for OME. Antibiotic treatment is predicated on the assumption that microorganisms responsible for OME are the same ones which produce acute otitis media. This may not always be the case. enterococcus faecalis (formerly known as beta-hemolytic group D streptococcus) was isolated in pure culture from 3 middle ears of two patients with OME. The significance of the isolation of this bacteria, an enteric organism which is infrequently found in upper respiratory tracts, is its lack of susceptibility to the usually prescribed oral antibiotics. In each of the children, failure to respond to antibiotics led to tympanocentesis and culture followed by middle ear drainage with insertion of middle ear ventilating tubes. Unless intravenous antibiotics are used, surgical drainage should be the procedure of choice when E. faecalis is found in the middle ear.
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keywords = culture
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4/4. Isolation of chlamydia trachomatis from the middle ear aspirates of otitis media.

    chlamydia trachomatis was cultured from the middle ear aspirates of patients with acute otitis media and otitis media with effusion (OME) to assess the relationship between the microorganism and middle ear disease. The agent was recovered in 2 of 6 patients with acute otitis media, in 3 of 13 with acute OME and in 9 of 31 with chronic OME. serum antibody to the agent was detected in 8 of 9 patients with C. trachomatis infection in the middle ear. Chlamydial infection was found, serologically or by isolation of the agent from the genital tract, in the parents of 5 of 6 children with the infection. Therefore perinatal transmission appeared to be the most probable mode of infection in the infants. These studies indicate that C. trachomatis causes middle ear diseases more often than has been suspected.
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ranking = 1
keywords = culture
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