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Abstract
Specimens of middle ear effusion and adenoid tissue were studied for bacteria and pneumococcal capsu-lar antigen in 107 patients with secretory otitis media. 120 of 163 middle ear effusion samples (73.6%) were negative on bacterial culture. Hemophilus influenzae was present in 9.2% and Streptococcus pneurnoniae in 1.8%. Hemo philus influenzae was cultured from 44.8% and Strepto coccus pneurnoniae from 35.5% of 107 adenoid tissue specimens. Free pneumococcal capsular antigen was demonstrated in 10.4% of the middle ear fluids and this figure rose to 23% when antigen was liberated from the immune complexes by heating. The corresponding figures for adenoid tissue suspension were 27.1 % and 39%. The adenoid tissue or the lymphoid tissue of the entire oro-pharynx could act as the source of antigen which could maintain immune complex disease in some patients suffer ing from secretory otitis media.
