Otitis Media with Effusion Associated with Chlamydia trachomatis Infection in Children

In an attempt to discover the role of Chlamydia trachomatis in the pathogenesis of middle ear diseases, we examined middle ear effusions (MEEs) from 69 patients with otitis media with effusion (OME) for the presence of C. trachomatis and antibodies to the organism. Age distribution was 1 to 14 years (mean age 6.1 years). C. trachomatis was isolated by the culture method from MEE of 11 of 31 (35.5%) patients and from 2 of 5 (40.0 %) nasopharyngeal specimens. Chlamydial antigen, however, was found in 29 MEEs from 57 patients (50.9 %) using an immunofluorescent method (Syva, ‘MicroTrak’). Antibodies to the agent were found in 23 MEEs of 40 patients (57.5 %) using the Micro-IF test. Antigen and antibodies were determined at the same time and both were detected in 20 of 40 (50.0 %) patients. Although the isolation rate for C. trachomatis from MEE was low, antigen and antibodies were detected in 50.0 % of patients with OME. These results suggest the possibility that immune complexes are formed with C. trachomatis in the middle ear, and that these immune complexes cause the mucosal damage responsible for chronic middle ear mucosal irritation.