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Otitis media in influenza: causes, symptoms, diagnosis, treatment

 
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Last reviewed: 04.07.2025
 
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Influenza is an acute viral infectious disease that primarily affects the respiratory tract and causes general weakness, fatigue, headache, muscle and joint pain. Influenza pathogens are orthomyxoviruses and are divided into serological types A (A1, A2), B and C. The source of the pathogen is a sick person, especially in the first 5 days of illness. Infection is by airborne droplets. When the virus dies, endotoxin is released, which, getting into the blood, causes damage to the capillaries and precapillaries, the central nervous system. Bacterial microbiota of the upper respiratory tract, which is activated by a decrease in immunity, causes inflammatory processes in the paranasal sinuses, larynx, trachea, bronchi and lungs. The same reason underlies acute influenza otitis.

Acute influenza otitis media most often occurs during flu epidemics and in some years affects up to 20% of those who fall ill with this viral disease. Bilateral lesions, the presence of herpetic eruptions and hemorrhagic phlyctenas on the surface of the eardrum and in the depth of the auditory canal around the tympanic ring, as well as the presence of hemotympanum, confirm the influenza genesis of otitis, which arose as a result of hematogenous spread of infection.

Symptoms of otitis in flu. The onset of the disease is characterized by severe pain in the ear (ears) and head, insomnia, a rise in temperature to 39 ° C, general weakness. During otoscopy, numerous herpetic eruptions covered with a translucent thin layer of epidermis are revealed on the surface of the eardrum, when the integrity of which is violated, their serous-bloody or purely hemorrhagic contents flow into the external auditory canal, which is why this form of acute otitis is called "hemorrhagic otitis".

The occurrence of perforation of the eardrum contributes to the addition of common microbiota to the influenza infection, which leads to the occurrence of acute purulent otitis media, the course of which can last from 7 to 20 days. During influenza epidemics, when the virus has a special virulence, people with weakened immunity and not vaccinated against this strain develop more severe forms of middle ear disease with a tendency to develop various complications (mastoiditis, phlebitis of the sigmoid sinus, necrotic forms of acute inflammation of the middle ear with significant destructive phenomena of sound-conducting structures). As a rule, such forms of influenza otitis media are accompanied by toxic cochleitis and persistent hearing impairment.

Treatment of influenza otitis media is carried out in the same way as banal otitis, against the background of general anti-influenza therapeutic measures. Timely use of antibiotics and sulfonamides can lead to influenza otitis media to reverse development within 4-6 days, and complex antineuritic treatment can prevent toxic damage to the labyrinthine and retrolabyrinthine nerve structures.

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