Demonstration of Chlamydia pneumoniae in the adenoid from children with and without secretory otitis media using immunohistochemistry and PCR.

Chlamydia pneumoniae has been found in patients with middle ear inflammation. The adenoid, which has a central role in the development of secretory otitis media (SOM), may act as a reservoir for bacteria causing ear infection. Adenoid tissue was examined for the presence of C. pneumoniae. Twenty children undergoing adenoidectomy because of hyperplastic adenoids, 10 with SOM and 10 without SOM, were examined with nasopharyngeal swabs for routine bacteriological culture, serology for C. pneumoniae and throat swabs for C. pneumoniae PCR. The removed tissues were analyzed for C. pneumoniae using immunohistochemical (IHC) analysis and PCR. In the group of children with SOM samples were also taken from the middle ear fluid for routine bacteriological culture and PCR for C. pneumoniae. C. pneumoniae was found in the adenoid by PCR in 3 cases from each group and from all 20 children by IHC. Four children in each group had increased levels of specific antibodies to C. pneumoniae. Two children with SOM had high antibody titers and a positive PCR from a throat swab. Two children were PCR-positive for C. pneumoniae in fluid from the middle ear. The significance of these findings is not yet clear.