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There are conflicting views concerning middle ear infections due to Chlamydia trachomatis. To ascertain the etiological role of this agent in otitis media with effusion, middle ear effusions were cultured for C. trachomatis and other bacterial flora. A total of 102 patients with otitis media with effusion (OME) were recruited for this study. The study population included 66 patients with acute OME (AOME) and 36 patients with chronic OME (COME). As Chlamydia pneumoniae, the third species of Chlamydia, is also known to be isolated from middle ear effusion of OME, the fluorescent-antibody technique using anti-C. pneumoniae or anti-C. trachomatis antibodies was employed in order to identify the inclusion bodies isolated on HeLa 229 cells as C. trachomatis. C. trachomatis was recovered from 7 patients (10.6%) with AOME and from 8 (22.2%) patients with COME. Bacteria were cultured from 20 of 63 patients with AOME and from 13 of 28 patients with COME. Pathological bacteria were cultured from only 2 patients with C. trachomatis infection in the middle ear. Only normal skin flora, no bacterial pathogens, were isolated from the remainder. Antibodies to C. trachomatis in serum were measured by a microimmunofluorescent method in 13 patients with C. trachomatis infection in the middle ear. Antichlamydial antibody of the IgG type was detected in 84.6% (11/13) of these patients. These results suggest that C. trachomatis causes middle ear infections and plays an etiological role in the pathogenesis of otitis media with effusion.

THE PATHOGENIC ROLE OF CHLAMYDIA TRACHOMATIS IN OTITIS MEDIA WITH EFFUSION