Endotoxin in middle-ear effusions from patients with chronic otitis media with effusion

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Abstract
Endotoxin concentrations were determined in middle-ear effusions (MEE) from 89 children with chronic otitis media by using the Limulus amoebocyte lysate assay. Mean concentrations of endotoxin in Haemophilus influenzae-positive and Streptococcus pneumoniae-positive MEE were 157 and 21.8 ng/ml, respectively, and were significantly different (P < 0.01). Endotoxin was also found in Gram stain-positive, culture-negative and Gram stain-negative, culture-negative MEE; the levels were not significantly different (P > 0.05). The endotoxin concentrations in both groups of culture-negative MEE were significantly lower than those found in MEG that grew H. influenzae or S. pneumoniae (P < 0.05). Thus, endotoxin is present in a high percentage of human MEE, including those that are culture-negative, and may contribute to the pathogenesis of otitis media with effusion.