Clinical and immunological study of acute purulent otitis media in young children

We surveyed 35 patients who had been diagnosed with acute purulent otitis media (AOM) who were admitted to our department between 1995 and 1998. Penicillin-resistant Streptcoccus peumoniae (PRSP) was isolated from 15 patients (42%). The efficacy of cefotaxim (CTX) was satisfactory in all cases in which it was used. However, 4 patients in whom cefotium (CTM) was used showed no improvement, and 2 had recurrence of AOM. Ten of 15 patients who suffered from PRSP underwent immunologic examinations. The IgG2 level of one case was reduced; this patient also had MRSA infection. Levels of serum IgG2 antibody specific for S. peumoniae were low in 2 patients, one of whom had recurrent AOM, and the other had complications of mastoiditis. A decrease in plasma IgG2 levels might predict recurrent or severe AOM. Immunological studies with reagents such as specific antibody for S. peumoniae might be useful for prognostic estimation of AOM.