The Role of Respiratory Syncytial Virus in Otitis Media in Children

Abstract

Thirty-three children with acute respiratory infection and intratympanic mucus or fluid accumulation were studied during a respiratory syncytial (RS) virus outbreak. Throat swabs and middle ear aspirates were cultured for virus using a direct inoculation technique. RS virus was recovered from the throat swabs of 18, from one or both ears of 7 of these virus-positive subjects, and with about equal frequency from ears showing signs of slight inflammation and ears with injected, reddened and/ or bulging eardrums. It was recovered from two aspirates obtained at subsequent punctures from the same ear, from aspirates also yielding a bacterial pathogen, and from the aspirate of a subject no younger than 3 years old. None of the children with virus-neagtive throat swabs showed virus in their aspirates. “Within this group there was a strikingly high number of subjects displaying evidence of recent RS virus infection (CF antibodies to a high titer in the acute serum). The origin of the mucus, the clinical significance of its presence in the middle ear, the variations in the isolation frequency, and factors contributing to successful RS virus isolation will be discussed.