Severe acute otitis media and mastoiditis caused by group A beta-hemolytic streptococcus

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Laakso , J T , Rissanen , V , Ruotsalainen , E , Korpi , J , Laulajainen-Hongisto , A , Sivonen , V & Sinkkonen , S T 2021 , ' Severe acute otitis media and mastoiditis caused by group A beta-hemolytic streptococcus ' , Laryngoscope Investigative Otolaryngology , vol. 6 , no. 5 , pp. 1158-1166 .

Title: Severe acute otitis media and mastoiditis caused by group A beta-hemolytic streptococcus
Author: Laakso, Juha T.; Rissanen, Valtteri; Ruotsalainen, Eeva; Korpi, Jarkko; Laulajainen-Hongisto, Anu; Sivonen, Ville; Sinkkonen, Saku T.
Contributor organization: Korva-, nenä- ja kurkkutautien klinikka
HUS Head and Neck Center
HUS Inflammation Center
Infektiosairauksien yksikkö
University of Helsinki
Date: 2021-10
Language: eng
Number of pages: 9
Belongs to series: Laryngoscope Investigative Otolaryngology
ISSN: 2378-8038
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.
Subject: acute mastoiditis
acute otitis media
group A beta-hemolytic streptococcus
health-related quality of life
Streptococcus pyogenes
3125 Otorhinolaryngology, ophthalmology
Peer reviewed: Yes
Rights: cc_by_nc_nd
Usage restriction: openAccess
Self-archived version: publishedVersion

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