Buchman C A, Doyle W J, Skoner D P, Post J C, Alper C M, Seroky J T, Anderson K, Preston R A, Hayden F G, Fireman P
Department of Otolaryngology, University of Pittsburgh School of Medicine, Pennsylvania, USA.
J Infect Dis. 1995 Nov;172(5):1348-51. doi: 10.1093/infdis/172.5.1348.
To better understand the significance of viral upper respiratory tract infections in the pathogenesis of acute otitis media (OM), 27 adults underwent intranasal inoculation with influenza A virus. Monitoring consisted of antibody titer determination, tympanometry, and otoscopy. Microbiologic analysis consisted of cultures and polymerase chain reaction (PCR)-based detection for influenza A virus, Streptococcus pneumoniae, Haemophilus influenzae, and Moraxella catarrhalis. All subjects became infected with the challenge virus. By day 4, 16 (59%) developed middle ear pressures of -100 mm H2O or below and 4 (25%) of them developed OM. One subject (4%) developed purulent OM requiring myringotomy for pain relief. Middle ear effusion cultures were negative. PCR analysis of that subject's middle ear effusion and nasal washes were positive for influenza A virus and S. pneumoniae. These findings support a causal role for viral upper respiratory tract infections in the pathogenesis of OM, possibly mediated by middle ear underpressures and viral and bacterial middle ear infection.
为了更好地理解病毒性上呼吸道感染在急性中耳炎（OM）发病机制中的重要性，27名成年人接受了甲型流感病毒的鼻内接种。监测包括抗体滴度测定、鼓室导抗图检查和耳镜检查。微生物学分析包括培养以及基于聚合酶链反应（PCR）的甲型流感病毒、肺炎链球菌、流感嗜血杆菌和卡他莫拉菌检测。所有受试者均感染了攻击病毒。到第4天，16名（59%）受试者的中耳压力降至-100 mm H2O或更低，其中4名（25%）发生了中耳炎。1名受试者（4%）发生了化脓性中耳炎，需要进行鼓膜切开术以缓解疼痛。中耳积液培养结果为阴性。对该受试者的中耳积液和鼻腔冲洗液进行的PCR分析显示，甲型流感病毒和肺炎链球菌呈阳性。这些发现支持病毒性上呼吸道感染在中耳炎发病机制中起因果作用，可能是由中耳负压以及病毒和细菌引起的中耳感染介导的。
