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The microbiology of acute and chronic sinusits and otitis media: a review

  • P. B. van Cauwenberge
  • A. -M. Vander Mijnsbrugge
  • K. J. A. O. Ingels
Article

Summary

There exists no real controversy about the role of aerobic bacteria in acute sinusitis and in acute otitis media. The “infernal trio”Streptococcus pneumoniae, Haemophilus influenzae andMoraxella catarrhalis are by far the most common pathogens in these acute infections. On the contrary, there is still much debate about the normal flora of the paranasal sinuses and the middle ear, although there are some reports of the presence of anaerobes and aerobes in the majority of the normal paranasal sinuses. In chronic sinusitis bacterio-logical cultures show a greater variation than those in acute sinusitis. Nonetheless, it is demonstrated in most studies that besides the “infernal trio” additional bacteria are present, including anaerobes and gram negative bacteria. In otitis media with effusion (OME) we find the same bacteria as in acute otitis media (AOM) and a pathologic flora in the nasopharynx seems to be important for both AOM and OME. In chronic otitis cultures are nearly always positive and revealPseudomonas species,Klebsiella pneumoniae, Staphylococcus aureus, Proteus species and anaerobes.

Key words

Otitis media Sinusitis Bacteriology 

References

  1. 1.
    Almadori G, Bastianini L, Bistoni F, Maurizi M, Ottaviani F, Paludetti G, Scuteri F (1986) Microbial flora of nose and paranasal sinuses in chronic maxillary sinusitis. Rhinology 24:254–264Google Scholar
  2. 2.
    Arola M, Ziegler T, Ruuskanen O (1990) Respiratory virus infection as a cause of prolonged symptoms in acute otitis media. J Pediatr 116:697–701PubMedCrossRefGoogle Scholar
  3. 3.
    Brook I (1979) Bacteriology and treatment of chronic otitis media. Laryngoscope 89:1129–11134PubMedGoogle Scholar
  4. 4.
    Brook I (1981) Aerobic and anaerobic flora of normal maxillary sinuses. Laryngoscope 91:372–376PubMedGoogle Scholar
  5. 5.
    Brook I (1989) Bacteriology of chronic maxillary sinustitis in adults. Ann Otol Rhinol Laryngol 98:426–428PubMedGoogle Scholar
  6. 6.
    Brook I, Yocum P (1989) Quantitative bacterial cultures and Beta-Lactamase activity in chronic suppurative otitis media. Ann Otol Laryngol 98:293–297Google Scholar
  7. 7.
    Brook I, Yocum P, Shah K, Feldman B, Epstein S (1983) Aerobic and anaerobic bacteriologic features of serous otitis media in children. Am J Otolaryngol 4:398–392Google Scholar
  8. 8.
    Carenfelt C, Lundberg C, Nord C-E, Wretlind B (1978) Bacteriology of maxillary sinusitis in relation to quality of the retained secretion. Acta Otolaryngol (Stockh) 86:298–302Google Scholar
  9. 9.
    Cauwenberge P van (1982) Otitis media with effusion. Functional morphology and physiopathology of the structures involved. Acta Othorhinolarnygol Belg 36:196–213Google Scholar
  10. 10.
    Cauwenberge P van (1988) Secretory otitis media. An epidemiological, clincal and experimental study (in Dutch). Thesis, GhentGoogle Scholar
  11. 11.
    Cauwenberge P van, Verschraegen G, Renterghem L van (1976) Bacteriological findings in sinusitis. Scand J Infect Dis [Suppl] 9:72–77Google Scholar
  12. 12.
    Chole RA (1986) Acute and chronic infection of the temporal bone including oitis media with effusion. In: Cummings CW, Frederickson JM, Harker LA, Krause CJ, Schuller DE (eds) Otolaryngology—head and neck surgery. 1st edn. Mosby, St Louis, p 2966Google Scholar
  13. 13.
    Diamond C, Sisson PR, Kearns AM, Ingham HR (1989) Bacteriology of chronic otitis media with effusion. J Laryngol Otol 103:369–371PubMedGoogle Scholar
  14. 14.
    Doyle PW, Woodham JD (1991) Evaluation of the microbiology of chronic ethmoid sinusitis. J Clin Microbiol 29:2396–2400PubMedGoogle Scholar
  15. 15.
    Karma P, Jokipii L, Ojala K, Jokipii AMM (1978) Bacteriology of the chronically discharging middle ear. Acta Otolaryngol (Stockh) 86:110–114Google Scholar
  16. 16.
    Karma P, Jokipii L, Sipilä P, Louotonen J, Jokipii AMM (1979) Bacteria in chronic maxillary sinusitis. Arch Otorhinolaryngol 105:386–390Google Scholar
  17. 17.
    Maran A, Lund V (1990) Basic sciences. In: Lund V, Maran A (eds) Clinical rhinology, 1st edn. Thieme, Stuttgart, pp 47–48Google Scholar
  18. 18.
    Muntz HR, Lusk RP (1991) Bacteriology of the ethmoid bullae in children with chronic sinusitis. Arch Otolaryngol Head and Neck Surg 117:179–182Google Scholar
  19. 19.
    Ogawa H, Hashiguch K, Kazuyama Y (1990) Isolation ofChlamydia trachomatis from the middle ear aspirates of otitis media. Acta Otolaryngol (Stockh) 110:105–109Google Scholar
  20. 20.
    Rantanen T, Arvilommi H (1973) Double-blind trial of doxicycline in acute maxillary sinusitis. Acta Otolaryngol (Stockh) 76:58–62Google Scholar
  21. 21.
    Sriwardhana KB, Howard AJ, Dunkin KT (1989) Bacteriology of chronic otitis media with effusion. J Laryngol Otol 103:325–256Google Scholar
  22. 22.
    Stenfors LE, Räisänen S (1989) The bacterial flora of the nasopharynx, with special reference to middle ear pathogens. Acta Otolaryngol (Stockh) 108:122–125Google Scholar

Copyright information

© Springer-Verlag 1993

Authors and Affiliations

  • P. B. van Cauwenberge
    • 1
  • A. -M. Vander Mijnsbrugge
    • 1
  • K. J. A. O. Ingels
    • 1
  1. 1.Department of OtorhinolaryngologyUniversity HospitalGhentBelgium

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