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

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dc.contributor.author Laakso, Juha T.
dc.contributor.author Rissanen, Valtteri
dc.contributor.author Ruotsalainen, Eeva
dc.contributor.author Korpi, Jarkko
dc.contributor.author Laulajainen-Hongisto, Anu
dc.contributor.author Sivonen, Ville
dc.contributor.author Sinkkonen, Saku T.
dc.date.accessioned 2021-11-01T17:58:01Z
dc.date.available 2021-11-01T17:58:01Z
dc.date.issued 2021-10
dc.identifier.citation 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
dc.identifier.other PURE: 169970060
dc.identifier.other PURE UUID: 8d7894b5-0e87-4a04-bbfc-77a10893f77c
dc.identifier.other WOS: 000696241500001
dc.identifier.uri http://hdl.handle.net/10138/335925
dc.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. en
dc.format.extent 9
dc.language.iso eng
dc.relation.ispartof Laryngoscope Investigative Otolaryngology
dc.rights cc_by_nc_nd
dc.rights.uri info:eu-repo/semantics/openAccess
dc.subject acute mastoiditis
dc.subject acute otitis media
dc.subject group A beta-hemolytic streptococcus
dc.subject health-related quality of life
dc.subject Streptococcus pyogenes
dc.subject UNITED-STATES
dc.subject EPIDEMIOLOGY
dc.subject INFECTIONS
dc.subject PYOGENES
dc.subject DISEASE
dc.subject COMPLICATIONS
dc.subject CHILDREN
dc.subject 3125 Otorhinolaryngology, ophthalmology
dc.title Severe acute otitis media and mastoiditis caused by group A beta-hemolytic streptococcus en
dc.type Article
dc.contributor.organization Korva-, nenä- ja kurkkutautien klinikka
dc.contributor.organization HUS Head and Neck Center
dc.contributor.organization HUS Inflammation Center
dc.contributor.organization Infektiosairauksien yksikkö
dc.contributor.organization University of Helsinki
dc.description.reviewstatus Peer reviewed
dc.relation.doi https://doi.org/10.1002/lio2.659
dc.relation.issn 2378-8038
dc.rights.accesslevel openAccess
dc.type.version publishedVersion

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