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 . https://doi.org/10.1002/lio2.659

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.
Other contributor: University of Helsinki, Korva-, nenä- ja kurkkutautien klinikka
University of Helsinki, HUS Head and Neck Center
University of Helsinki, HUS Inflammation Center
University of Helsinki, HUS Head and Neck Center
University of Helsinki, HUS Head and Neck Center
University of Helsinki, University of Helsinki
University of Helsinki, HUS Head and Neck Center




Date: 2021-10
Language: eng
Number of pages: 9
Belongs to series: Laryngoscope Investigative Otolaryngology
ISSN: 2378-8038
DOI: https://doi.org/10.1002/lio2.659
URI: http://hdl.handle.net/10138/335925
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
UNITED-STATES
EPIDEMIOLOGY
INFECTIONS
PYOGENES
DISEASE
COMPLICATIONS
CHILDREN
3125 Otorhinolaryngology, ophthalmology
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