The aim of this study is to investigate the role of adenovirus and respiratory syncytial virus in the cause of chronic otitis media with effusion by use of the polymerase chain reaction for detection. The polymerase chain reaction has proved to be more sensitive and specific than viral cultures and immunoassays in the detection of viruses in other specimens. Adenovirus and respiratory syncytial virus were chosen because these viruses have been the most commonly isolated viruses in middle ear effusions in studies using other techniques. The effusions (132 total) were sterilely collected from 88 children undergoing myringotomy and ventilation tube placement for chronic otitis media with effusion. Nine (6.8%) specimens were positive for adenovirus by the polymerase chain reaction, and 13 (9.9%) were positive for respiratory syncytial virus by the polymerase chain reaction. Only one specimen was positive for adenovirus and respiratory syncytial virus by viral culture and immunofluorescence, respectively. Our results show that the polymerase chain reaction can be used to detect adenovirus and respiratory syncytial virus in chronic middle ear effusions and that PCR is more sensitive than viral culture and immunofluorescence techniques.
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References
1.
BluestoneCDKleinJOOtitis media with effusion, atelectasis, and eustachian tube dysfunction. In: BluestoneCDStoolSE, eds. Pediatric otolaryngology. Philadelphia: WB Saunders Co., 1983: 356–512.
2.
CasselbrantMLBrostoffLMCantekinEICarriganVMBluestoneCDOtitis media in children in the United States. Ann Otol Rhinol Laryngol1988;(suppl133):s12–3.
3.
HendersonFWCollierAMSanyalMAA longitudinal study of respiratory viruses and bacteria in the etiology of acute otitis media with effusion. N Engl J Med1982; 306: 1377–83.
4.
HowieVMPloussardJHSloyerJ.The “otitis prone” condition. Am J Dis Child1975;129:676–8.
5.
TeeleDWKleinJORosnerBAEpidemiology of otitis media in children. Ann Otol Rhinol Laryngol1980;(suppl89):s5–6.
6.
WaldEREpidemiology of the microbiology of acute otitis media. Ann Otol Rhinol Laryngol1990;(suppl149):s40–2.
7.
DiamondDSissonPRKearnsAMInghamHRBacteriology of chronic otitis media with effusion. J Laryngol Otol1989;103:369–71.
GiebinkGSJuhnSKWeberMLLeCTThe bacteriology and cytology of chronic otitis media with effusion. Pediatr Infect Dis1982;1:98–103.
10.
NonomuraNGiebinkFSHaradaTZeltermanDJuhnSKEarly biochemical events in pneumococcal otitis media: Arachidonic acid metabolites in middle ear fluid. Ann Otol Rhinol Laryngol1991;100:385–8.
11.
BluestoneCDRole of eustachian tube function in otitis media: Current concepts and relation to management. Ann Otol Rhinol Laryngol1985;(suppl120):s48–9.
12.
LimDJPathogenesis of otitis media with effusion. Pediatr Infect Dis1982;1:s14–s35.
13.
GiebinkGSRipleyMLWrightPFEustachian tube histo-pathology during experimental influenza A virus infection in the chinchilla. Ann Otol Rhinol Laryngol1987;96:199–206.
14.
GiebinkGSWrightPFDifferent virulence of influenza A virus strains and susceptibility to pneumococcal otitis media in chinchillas. Infect Immun1983;41:913–20.
15.
AdlingtonPHooperWKVirus studies in secretory otitis media. J Laryngol Otol1980;94:191–6.
16.
BakaletzLODanielsRLLimDJModeling adenovirus type 1–induced otitis media in the chinchilla: Effect on ciliary activity and fluid transport function of eustachian tube mucosal epithelium. J Infect Dis1993;168:865–72.
17.
BerglundBSalmivalliAGronroosJAThe role of respiratory syncytial virus in otitis media in children. Acta Otolaryngol1967;63:445–54.
18.
BerglundBSalmivalliAToivanenP.Isolation of respiratory syncytial virus from middle ear exudates of infants. Acta Otolaryngol1966;61:475–87.
19.
ChonmaitreeTHowieVMTruantALPresence of respiratory visues in middle ear fluids and nasal wash specimens from children with acute otitis media. Pediatrics1986;77:698–702.
20.
KleinJOMicrobiology of otitis media. Ann Otol Rhinol Laryngol1980;89(suppl 68):98–101.
21.
KleinBSDolleteFRYolkenRHThe role of respiratory syncytial virus and other viral pathogens in acute otitis media. J Pediatr1982;101:16–20.
22.
MeurmanOHSarkkinnenHKPuhakkaHJVirlainenESMeurmanOHLocal IgA class antibodies against respiratory viruses in middle ear and nasopharyngeal secretions of children with secretory otitis media. Laryngoscope1980;90:304–11.
23.
RuuskanenOArolaMPutto-LaurilaAMertsolaJMeurmanOVilijanenMKHalonenP.Acute otitis media and respiratory virus infections. Pediatr Infect Dis J1989; 8: 94–9.
24.
SarkkinenJRuuskanenOMeurmanOPuhakkaHViro-LainenEEskolaJ.Identification of respiratory virus antigens in middle ear fluids of children with acute otitis media. J Infect Dis1985;151:444–8.
25.
TillesJGKleinJOJaoRLAcute otitis media in children. N Engl J Med1967;277:613–8.
26.
YamaguchiTUrasawaTKatauraA.Secretory immunoglobulin A antibodies to respiratory viruses in middle ear effusion of chronic otitis media with effusion. Ann Otol Rhinol Laryngol1984;93:73–5.
27.
AllardAGironesRJutoPWadellG.Polymerase chain reaction for detection of adenovirus in stool samples. J Clin Microbiol1990;28:2859–67.
28.
OkamotoOKudoKShirotoriKNakazawaM.Detection of genomic sequences of respiratory syncytial virus in otitis media with effusion in children. Ann Otol Rhinol Laryngol1992;(suppl147):s7–10.
29.
PatonAWPatonJCLawrenceAJGoldwaterPNHarrisRJRapid detection of respiratory syncytial virus in nasopharyngeal aspirates by reverse transcription and polymerase chain reaction amplification. J Clin Microbiol1992;30:901–4.
30.
RotbartHADiagnosis of enteroviral meningitis with the polymerase chain reaction. J Pediatr1990;117:85–9.
31.
MullisKBFaloonaFASpecific synthesis of DNA in vitro via a polymerase-catalyzed chain reaction. Methods Enzymol1987;155:335–50.
EmbilJAGoldbloomALMcFarlaneESIsolation of cytomegalovirus from middle ear effusion. J Pediatr1985; 107: 435–6.
34.
ChomczynskiPSacchiN.Single-step method of RNA isolation by acid guanidinium thiocyanate-phenol-chloroform extraction. Anal Biochem1987;162:156–9.
35.
BaumS.Adenovirus. In: MandellGLDouglasRGJrBennettJE, eds. Principles and practices of infectious diseases. New York: Churchill Livingstone, 1990: 1185–90.
36.
JohnsonPRCollinsPLThe fusion glycoprotein of human respiratory syncytial virus of subgroups A and B: Sequence conservation provides a structural basis for antigenic relatedness. J Gen Virol1988;69:2623–8.
37.
HiguchiRKwokS.Avoiding false positives with PCR. Nature1989;339:237–8.
38.
AureliusEJohanssonBSkoldenbergB.Rapid diagnosis of herpes simplex encephalitis by nested polymerase chain reaction assay of cerebrospinal fluid. Lancet1991;337:189–91.
GiebinkGSBerzinsIKMarkerSCExperimental otitis media after nasal inoculations of Streptococcus pneumoniae and influenza A virus in chinchillas. Infect Immun1980; 30: 445–50.
41.
LimDJYoshihiroOMyung-HyunDDeMariaTFUltra-structural pathology of the tubotympanum following experimental influenza A virus induced otitis media. In: LimDJ, ed. Recent advances in otitis media. Philadelphia: BC Decker Inc., 1988: 436–8.
42.
SugiyamaMYoshiakiNKyojiTChangKCRespiratory viruses and mycoplasma pneumoniae infections at the time of acute exacerbation of chronic otitis media. Aura Nasus Larynx (Tokyo)1984;11:139–47.
