Chonmaitree T, Howie V M, Truant A L
Pediatrics. 1986 May;77(5):698-702.
During a 28-month period, 84 children with acute otitis media were studied by viral and bacterial cultures of middle ear fluid and viral cultures of nasal lavage fluid. Viruses were isolated from the middle ear fluid of 17 (20%) patients. Evidence of viral infection was demonstrated by positive viral cultures of middle ear fluid and/or nasal lavage fluid in 33 (39%) patients. Rhinovirus in one patient and influenza b virus in another were the only pathogens isolated. Influenza virus, enterovirus, and rhinovirus were the most common viruses found in middle ear fluids. Parainfluenza virus, adenovirus, and respiratory syncytial virus were found less often. In 82% of cases, the virus isolated from middle ear fluid was also isolated from nasal lavage fluid, but only 44% of viruses found in nasal lavage fluid were also found in middle ear fluid. Mixed bacterial and combined viral-bacterial infections were common. Only 15% of patients had no pathogen isolated from middle ear fluids. Using tissue culture techniques, we demonstrated that enterovirus and rhinovirus are also common middle ear pathogens. Our data reemphasize the significance of viruses as etiologic agents of acute otitis media and propose several questions regarding the viral-bacterial interactions and the types of viruses involved in the pathogenesis of the disease.
在28个月的时间里，对84例急性中耳炎患儿进行了中耳积液的病毒和细菌培养以及鼻腔灌洗液的病毒培养研究。17例（20%）患者的中耳积液中分离出病毒。33例（39%）患者的中耳积液和/或鼻腔灌洗液病毒培养呈阳性，证明存在病毒感染。仅分离出1例患者的鼻病毒和另1例患者的乙型流感病毒。流感病毒、肠道病毒和鼻病毒是在中耳积液中发现的最常见病毒。副流感病毒、腺病毒和呼吸道合胞病毒较少见。在82%的病例中，从中耳积液中分离出的病毒也能从鼻腔灌洗液中分离出来，但在鼻腔灌洗液中发现的病毒只有44%也能在中耳积液中找到。混合细菌感染以及病毒与细菌合并感染很常见。只有15%的患者中耳积液中未分离出病原体。通过组织培养技术，我们证明肠道病毒和鼻病毒也是常见的中耳病原体。我们的数据再次强调了病毒作为急性中耳炎病原体的重要性，并提出了几个关于病毒与细菌相互作用以及该疾病发病机制中涉及的病毒类型的问题。
