Effect of viral respiratory tract infection on outcome of acute otitis media

Tasnee Chonmaitree, Mary J. Owen, Janak A. Patel, Dawn Hedgpeth, David Horlick, Virgil M. Howie

Research output: Contribution to journalArticlepeer-review

143 Scopus citations


We prospectively studied 271 infants and children (2 months to 7 years of age) with acute otitis media (AOM) for viral and bacterial causes, outcome at the end of therapy, and frequency of recurrence within 1 month. Comprehensive virologic methods, including viral antigen detection, cell culture, and serologic studies, were used to diagnose viral infection of the respiratory tract middle ear, or both. Evidence of viral infection was found in 46% (124/271) of patients with AOM. Sixty-six patients (24%) had virus or viral antigen in the middle ear fluid; 50 of these patients (76%) also had bacteria in middle earffluid, and 16 (24%) had virus alone. More patients with AOM and combined bacterial and viral infection (51%) had persistent otitis (3 to 12 days after institution of antibiotic treatment), compared with those with only bacterial otitis (35%; p=0.05) or patients with only viral infection (19%; p<0.01). Of patients with only viral infection, 4 of 10 with virus in middle ear fluid had persistent otitis, compared with none of 11 patients who had virus only in nasal wash specimens or whose viral infection was diagnosed only by serologic studies. Our data suggest that viruses interact with bacteria and that concurrent viral infection can significantly worsen the clinical couse of bacterial AOM. The presence of virus in middle ear fluid may contribute to the pathogenesis and outcome of bacterial AOM. The mechanism of these interactions deserve further investigation.

Original languageEnglish (US)
Pages (from-to)856-862
Number of pages7
JournalThe Journal of Pediatrics
Issue number6
StatePublished - Jun 1992

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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