Influenza a virus-induced acute otitis media

Craig A. Buchman, William J. Doyle, David P. Skoner, J. Christopher Post, Cuneyt M. Alper, James T. Seroky, Kenneth Anderson, Robert A. Preston, Frederick G. Hayden, Philip Fireman, Garth D. Ehrlich

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


To better understand the significanceof 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 infiuenzae, 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 OMrequiring 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.

Original languageEnglish
Pages (from-to)1348-1351
Number of pages4
JournalJournal of Infectious Diseases
Issue number5
StatePublished - Nov 1995


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