Acute otitis media in measles

Measles is an acute infectious disease of viral etiology, accompanied by characteristic fever (38-39 ° C), catarrhal inflammation of the mucous membrane of the eyes, nasopharynx, pharynx and upper respiratory tract, specific rashes on the mucous membrane of the oral cavity, maculopapular rash on the skin. The causative agent of measles is the RNA-containing paramyxovirus Polynosa morbillorum. The source of the pathogen is a person sick with measles, who is infectious for others in the last 1-2 days of the incubation period (10 days). In countries where specific prevention is not carried out, those who have had measles make up 80-90% of the population, which is due to the almost absolute susceptibility of people to this infection. The disease, as a rule, leaves lifelong immunity. Repeated diseases occur in 1-2% of people and are associated with the lack of production of virus-neutralizing antibodies in the body.

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Symptoms of acute otitis in measles

Measles otitis occurs almost as often as scarlet fever otitis, at any stage of the development of measles infection, but usually at a late stage simultaneously with the development of the inflammatory process in the pharynx and bronchopulmonary system. A sudden rise in body temperature to high values should raise suspicion of the development of measles otitis. The detected inflammatory changes in the eardrum are an indication for its immediate paracentesis, since abstinence from this procedure leads to the same destructive changes in the formations of the tympanic cavity as in scarlet fever otitis. Unilateral measles otitis most often owes its tubular origin, bilateral - hematogenous.

Measles otitis begins with severe unilateral or bilateral ear pain, a rise in body temperature to 39-40°C, followed quickly by spontaneous perforation of the eardrum. Timely adequate local and general treatment, as a rule, ensures complete morphological and functional recovery, however, otitis that appears in the hypertoxic stage is fraught with the risk of meningoencephalitis even at the very beginning of measles otitis or its transition to a chronic purulent process of the middle ear.

There is also a necrotic form of measles otitis, which is similar in clinical course to a similar form of scarlet fever otitis, but in a less pronounced form. With measles otitis, the measles virus can penetrate the ear labyrinth, while no obvious signs of mastoiditis are observed. In this case, the hair cells of the cochlea are affected, leading to complete deafness, and with bilateral damage in children under 3 years old - to deaf-muteness, the cause of which in 3-4% of cases is measles otitis. Unilateral damage to the vestibular apparatus causes a violent vestibular syndrome, characteristic of serous or purulent labyrinthitis, manifested by dizziness and spontaneous nystagmus towards the healthy ear, impaired coordination tests, nausea and vomiting. In case of bilateral damage to the vestibular apparatus, the above symptoms are not so pronounced or are absent altogether, but a sharp disturbance of statics occurs, compensation of which takes months and is never complete. Damage to the ear labyrinth by the measles virus is irreversible.

Treatment of otitis in measles

Treatment of measles otitis involves the use of a whole range of measures (general, local procedures and manipulations, up to and including surgical intervention), which are used in severe forms of acute purulent otitis media.