Relationship between respiratory syncytial virus infection and acute otitis media in children

Auris Nasus Larynx. 2004 Dec;31(4):341-5. doi: 10.1016/j.anl.2004.07.005.


Background: Respiratory syncytial virus (RSV) is among the major causes of respiratory tract infection in infants and young children, and concomitant acute otitis media (AOM) often develops. However, there are only a few reports about AOM associated with RSV infection.

Methods: Two hundred and thirty children who were diagnosed as having RSV infection were studied by enzyme immunoassay (Testpack RSV) at the Department of Pediatrics of Tohoku Rosai Hospital from 1 November 2001 to 31 October 2002. In the patients with AOM, bacterial culture and detection of RSV antigen in the middle ear fluid (MEF) by enzyme immunoassay were performed, and the outcome was investigated.

Results: Among the 230 children, 120 (52.2%) were found to have AOM. In children under 2 years of age, the incidence of AOM was significantly higher (73.1%) than in the older children (29.7%). RSV antigen was positive in the MEF of 36 out of 52 patients with AOM (69.2%). In 24 of the 46 patients in whom both RSV antigen detection and bacterial culture of MEF were performed, RSV antigen was detected and bacterial culture was negative. Although the outcome of the first episode of AOM following RSV infection was favorable, relapse was observed in 31% of the patients.

Conclusion: These results confirm that patients with RSV infection have a high risk of AOM, especially children younger than 2 years of age, and suggest that RSV may be a direct cause of AOM at least in the early stage of infection with this virus. The necessity of performing careful follow-up of AOM after resolution of symptoms is suggested because relapse is common.

MeSH terms

  • Acoustic Impedance Tests
  • Acute Disease
  • Child
  • Child, Preschool
  • Haemophilus Infections / diagnosis
  • Humans
  • Immunoenzyme Techniques
  • Infant
  • Moraxellaceae Infections / diagnosis
  • Otitis Media with Effusion / microbiology
  • Otitis Media with Effusion / virology*
  • Respiratory Syncytial Virus Infections / complications*
  • Respiratory Syncytial Virus Infections / diagnosis
  • Respiratory Syncytial Viruses / isolation & purification
  • Streptococcal Infections / diagnosis