Panel discussion: pathogenesis of otitis media. Bacteriology and immunology.
Three features of otitis media with effusion (OME) are important in understanding its pathogenesis: 1. it is most common among children, when the eustachian tube is poorly developed; 2. it is most common during the winter months, when the common cold is prevalent; and 3. bacteria are found in a large number of middle ear effusions from OME patients. Although middle ear effusions are conventionally thought to be sterile, numerous recent investigations favor a bacterial pathogenesis of OME. Four possibilities can be considered: 1. bacteria are modified by antibiotics or antibodies, causing a lingering inflammation; 2. early antibiotic treatment may interfere with the development of local immunity; 3. bacterial antigen trapped in the middle ear causes immune injury leading to OME; and 4. bacterial endotoxin and inflammatory mediators cause middle ear effusions.
D000818:Animals; D000900:Anti-Bacterial Agents / Q000009:adverse effects; D000917:Antibody Formation; D000936:Antigen-Antibody Complex / Q000276:immunology; D000942:Antigens, Bacterial / Q000276:immunology; D001424:Bacterial Infections / Q000276:immunology* / Q000382:microbiology; D002634:Chemotaxis, Leukocyte; D002648:Child; D003167:Complement Activation; D005064:Eustachian Tube / Q000503:physiopathology; D006193:Haemophilus influenzae / Q000302:isolation & purification; D006801:Humans; D006968:Hypersensitivity, Delayed / Q000276:immunology; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007111:Immunity, Cellular; D009504:Neutrophils / Q000276:immunology; D010033:Otitis Media / Q000276:immunology*; D010034:Otitis Media with Effusion / Q000276:immunology* / Q000382:microbiology; D013210:Staphylococcus / Q000302:isolation & purification; D013296:Streptococcus pneumoniae / Q000302:isolation & purification; D014777:Virus Diseases / Q000276:immunology
D000900:Anti-Bacterial Agents; D000936:Antigen-Antibody Complex; D000942:Antigens, Bacterial