Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus
Abstract Objective To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta‐hemolytic streptococcus (GAS). Study design A retrospective cohort study. Methods The yearly incidence of inpatient care‐needin...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-10-01
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| Series: | Laryngoscope Investigative Otolaryngology |
| Subjects: | |
| Online Access: | https://doi.org/10.1002/lio2.659 |
| _version_ | 1819179170920398848 |
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| author | Juha T. Laakso Valtteri Rissanen Eeva Ruotsalainen Jarkko Korpi Anu Laulajainen‐Hongisto Ville Sivonen Saku T. Sinkkonen |
| author_facet | Juha T. Laakso Valtteri Rissanen Eeva Ruotsalainen Jarkko Korpi Anu Laulajainen‐Hongisto Ville Sivonen Saku T. Sinkkonen |
| author_sort | Juha T. Laakso |
| collection | DOAJ |
| description | Abstract Objective To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta‐hemolytic streptococcus (GAS). Study design A retrospective cohort study. Methods The yearly incidence of inpatient care‐needing GAS AOM/AM patients in our hospital catchment area between 2002 and 2018 was investigated. A detailed analysis was performed for cases treated during the last GAS epidemic in 2017‐2018. Anamnesis, signs and symptoms, pure‐tone audiometry results, treatment, complications, and outcome were collected from medical charts. Patients responded to an otology‐specific health‐related quality of life survey (EOS‐16) 1.5 to 3 years after their treatment. Results The number of GAS infections peaks at approximately 7‐year intervals. During 2017 and 2018, altogether 37 patients (29 adults and 8 children) were hospitalized due to GAS AOM/AM. AM was diagnosed in 14 (38%) patients. The disease progression was typically very rapid. At presentation, all patients had severe ear pain, 68% tympanic membrane perforation and discharge, 43% fever, and 43% vertigo. In pure‐tone audiometry, there was usually a marked mixed hearing loss at presentation. There was a significant recovery in both air and bone conduction thresholds; the pure tone average improvement from presentation was 32.3 ± 14.8 dB. Rapid strep tests (RST) proved to be more sensitive than bacterial culture in identifying GAS as a cause of AOM/AM. Conclusion GAS AOM/AM has a rapid onset. Hearing loss usually includes a sensorineural component, which is usually reversible with adequate treatment. RST seems to be useful in detecting GAS from middle ear discharge. Level of Evidence 4. |
| first_indexed | 2024-12-22T21:54:12Z |
| format | Article |
| id | doaj.art-314957307343498ebd84b7ebaef8f94f |
| institution | Directory Open Access Journal |
| issn | 2378-8038 |
| language | English |
| last_indexed | 2024-12-22T21:54:12Z |
| publishDate | 2021-10-01 |
| publisher | Wiley |
| record_format | Article |
| series | Laryngoscope Investigative Otolaryngology |
| spelling | doaj.art-314957307343498ebd84b7ebaef8f94f2022-12-21T18:11:17ZengWileyLaryngoscope Investigative Otolaryngology2378-80382021-10-01651158116610.1002/lio2.659Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcusJuha T. Laakso0Valtteri Rissanen1Eeva Ruotsalainen2Jarkko Korpi3Anu Laulajainen‐Hongisto4Ville Sivonen5Saku T. Sinkkonen6Department of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandDivision of Infectious Diseases, Department of Medicine Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandDepartment of Otorhinolaryngology—Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki FinlandAbstract Objective To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta‐hemolytic streptococcus (GAS). Study design A retrospective cohort study. Methods The yearly incidence of inpatient care‐needing GAS AOM/AM patients in our hospital catchment area between 2002 and 2018 was investigated. A detailed analysis was performed for cases treated during the last GAS epidemic in 2017‐2018. Anamnesis, signs and symptoms, pure‐tone audiometry results, treatment, complications, and outcome were collected from medical charts. Patients responded to an otology‐specific health‐related quality of life survey (EOS‐16) 1.5 to 3 years after their treatment. Results The number of GAS infections peaks at approximately 7‐year intervals. During 2017 and 2018, altogether 37 patients (29 adults and 8 children) were hospitalized due to GAS AOM/AM. AM was diagnosed in 14 (38%) patients. The disease progression was typically very rapid. At presentation, all patients had severe ear pain, 68% tympanic membrane perforation and discharge, 43% fever, and 43% vertigo. In pure‐tone audiometry, there was usually a marked mixed hearing loss at presentation. There was a significant recovery in both air and bone conduction thresholds; the pure tone average improvement from presentation was 32.3 ± 14.8 dB. Rapid strep tests (RST) proved to be more sensitive than bacterial culture in identifying GAS as a cause of AOM/AM. Conclusion GAS AOM/AM has a rapid onset. Hearing loss usually includes a sensorineural component, which is usually reversible with adequate treatment. RST seems to be useful in detecting GAS from middle ear discharge. Level of Evidence 4.https://doi.org/10.1002/lio2.659acute mastoiditisacute otitis mediagroup A beta‐hemolytic streptococcushealth‐related quality of lifeStreptococcus pyogenes |
| spellingShingle | Juha T. Laakso Valtteri Rissanen Eeva Ruotsalainen Jarkko Korpi Anu Laulajainen‐Hongisto Ville Sivonen Saku T. Sinkkonen Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus Laryngoscope Investigative Otolaryngology acute mastoiditis acute otitis media group A beta‐hemolytic streptococcus health‐related quality of life Streptococcus pyogenes |
| title | Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus |
| title_full | Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus |
| title_fullStr | Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus |
| title_full_unstemmed | Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus |
| title_short | Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus |
| title_sort | severe acute otitis media and mastoiditis caused by group a beta hemolytic streptococcus |
| topic | acute mastoiditis acute otitis media group A beta‐hemolytic streptococcus health‐related quality of life Streptococcus pyogenes |
| url | https://doi.org/10.1002/lio2.659 |
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