The Aetiology of Acute Otitis Media in Children: Occurrence of Bacteria, L Forms of Bacteria and Mycoplasma in the Middle Ear Exudate. Relationship between Bacterial Findings in the Middle Ear Exudate, Nasopharynx and Throat

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Abstract
From 75 children with primary acute otitis media middle ear exudate was collected by needle aspiration through the tympanic membrane and investigated with respect to the presence of bacteria, bacterial L forms and mycoplasmas. In 60 cases (80%) bacteria were found by cultivation. Diplococcus pneumoniae was isolated in 50.7%, Haemophilus influenzae in 14.7%, group A streptococci in 5.3% and Neisseria catarrhalis in 9.3%. From 2 cases D. pneumoniae was isolated only on media designed for the isolation of L forms. In 5 of the 15 cases with negative culture findings, evidence for a bacterial infection was obtained by microscopic examination of the exudate. Mycoplasma was not demonstrated in any of the exudates. The bacterial findings from the throat were of little value in assessing the aetiology of otitis media. On the other hand, the bacterium isolated from the middle ear exudate was isolated from the nasopharynx in all but one case. The bacterium that was isolated from the middle ear exudate was recovered from the nasopharynx in pure culture in about half the cases.