Sensori-neural hearing loss in acute otitis media due to beta-hemolytic streptococcus successfully treated with penicillin and prednisone.
This article reports a case of a 21-year-old woman with acute otitis media with effusion secondary to a virulent group A beta-hemolytic streptococcus infection that led to rapidly deteriorating hearing in an only hearing ear. This deterioration continued despite middle ear ventilation and high-dose intravenous cefazolin and subsequent high-dose aqueous penicillin. The addition of prednisone to her therapeutic regimen led to rapid hearing improvement and decrease in effusion production. A historical perspective on the use of steroids in treating otitis media and several theories for this reversal in clinical course are presented.
Department of Surgery, Dartmouth-Hitchcock Medical Center, Hanover, NH 03756.
S J
SJ
Fearrington
D J
DJ
Weider
D000208:Acute Disease; D000328:Adult; D001299:Audiometry; D004359:Drug Therapy, Combination; D005260:Female; D006319:Hearing Loss, Sensorineural / Q000175:diagnosis / Q000188:drug therapy* / Q000209:etiology; D006801:Humans; D010034:Otitis Media with Effusion / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D010400:Penicillin G / Q000627:therapeutic use*; D011241:Prednisone / Q000627:therapeutic use*; D013290:Streptococcal Infections / Q000150:complications / Q000188:drug therapy*; D013297:Streptococcus pyogenes
D010400:Penicillin G; D011241:Prednisone