Acute otitis media with measles

Measles is an acute infectious disease of the viral etiology, occurring with a characteristic fever (38-39 ° C), catarrhal inflammation of the mucous membrane of the eyes, nasopharynx, pharynx and upper respiratory tract, specific eruptions on the oral mucosa, patchy-papular rash on the skin. The measles activator is RNA-containing paramyxovirus Rolinosa morbillorum. The source of the pathogen is a person with measles, which is infectious to others in the last 1-2 days of the incubation period (10 days). In countries where specific prevention is not carried out, measles that have become ill are 80-90% of the population, which is due to the almost absolute susceptibility of people to this infection. The transferred illness, as a rule, leaves lifelong immunity. Repeated diseases occur in 1-2% of individuals and are associated with the lack of production in the body of virus-neutralizing antibodies.

[1], [2], [3], [4], [5], [6], [7], [8],

Symptoms of acute otitis in measles

Otitis cancers occur almost as often as scarlet fever, at any period of development of measles infection, but usually in the late stage, simultaneously with the onset of the inflammatory process in the pharynx and in the bronchopulmonary system. Sudden rise in body temperature to high values should cause suspicion of the occurrence of measles otitis. The detected inflammatory changes of the tympanic membrane are an indication for its immediate paracentesis, as abstinence from this procedure leads to the same destructive changes in the formation of the tympanic cavity, as in the case of scarlet fever. One-sided measles otitis is most often due to tubal origin, bilateral - hematogenous.

Otitis can begin with severe unilateral or bilateral pains in the ears, a rise in body temperature to 39-40 ° C, followed by a rapid spontaneous perforation of the tympanic membrane. Timely adequate local and general treatment provides, as a rule, complete morphological and functional recovery, but otitis, which appeared in the hypertoxic stage, fraught with the risk of meningoencephalitis even at the very beginning of the birth of measles otitis or its transition to the chronic suppurative 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 maze, and there are no obvious signs of mastoiditis. In this case, the cochlear hair cells of the cochlea are attacked, leading to complete deafness, and in bilateral lesions in children under 3 years of age - to deaf mutes, caused by measles otitis in 3-4% of cases. One-sided lesion of the vestibular apparatus causes a violent vestibular syndrome, characteristic of the serous or purulent labyrinthitis, manifested by dizziness and spontaneous nystagmus towards the healthy ear, a violation of coordination tests, nausea and vomiting. With bilateral lesion of the vestibular apparatus, the above symptoms are not so pronounced or absent at all, but there is a sharp violation of statics, the compensation of which occurs for months and is never complete. The defeat of the ear maze with measles virus is irreversible.

Treatment of otitis in measles

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