Otitis with diphtheria

Diphtheritic otitis rarely occurs independently, most often is a complication of diphtheria angina or cold and occurs in closed groups of children during epidemics of diphtheria. Diphtheritic otitis can also occur in adults, especially on wound postoperative surfaces in the region of the mastoid process.

Diphtheria is an acute infectious disease characterized by an inflammatory process in the pharynx, larynx, and trachea, less often in other organs with the formation of fibrinous films (raids) and general intoxication with a predominant lesion of the heart and peripheral nervous system.

[1], [2], [3], [4], [5]

Causes of otitis in diphtheria

The causative agent of diphtheria is the diphtheria bacillus (Corynebacterium diphtheriae), which produces a toxin (as opposed to a nontoxigenic diphtheria bacillus that does not cause disease). The source of the causative agent of infection is a diphtheria patient or a carrier of a toxigenic diphtheria bacillus, vegetating in the nose, nasopharynx and pharynx. Infection is transmitted by airborne droplets, through dishes and objects used by the patient with diphtheria. The patient becomes infectious in the last days of the incubation period (2-10 days) and continues to be throughout the disease until released from the pathogen.

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Symptoms of otitis in diphtheria

Diphtheria bacillus along with many other representatives of cocci microbiota can spread from the nasopharynx through the auditory tube into the tympanum, the cells of the mastoid process, cause perforation of the tympanic membrane and reach the external auditory canal. In the external auditory canal, purulent discharge is detected, containing fragments of false gray-brown films. The amount of pus and films gives an indirect idea of the volume and depth of destruction of the structures of the tympanum.

Particularly noteworthy is the so-called non-spot wounded diphtheria mastoiditis, described by German authors, observed in children hospitalized in the infectious department, operated on for mastoiditis. This form of diphtheritic otitis is characterized by accumulation in the postoperative wound of false films of dark gray color, hemorrhages and the presence of granulation tissue. Purulent discharge is fetid and contains diphtheria bacilli. The process of reparation in the postoperative wound is prolonged for a long time, in its environment, the current inflammatory process is sluggish. The discharge from such diphtheria-infected wounds is extremely contagious.

Complications of diphtheritic otitis include mastoiditis, thrombophlebitis of the sigmoid sinus and jugular vein (hence - sepsis), labyrinthitis, meningoencephalitis. The destruction of sound-conducting structures and the defeat of the ear maze leads to the development of various forms and degrees of deafness and vestibular dysfunction.

Diagnosis of diphtheritic otitis

The diagnosis of diphtheritic otitis is confirmed by bacteriological examination of secretions from the ear.

[10], [11], [12], [13]

Treatment of otitis in diphtheria

Local treatment corresponds to that in acute purulent inflammation of CpU. General treatment is carried out by the introduction of antidiphtheria serum and the use of massive doses of antibiotics, as well as measures for vitaminization and detoxification of the body.

Prognosis for otitis in diphtheria

The prognosis is generally favorable with timely recognition and adequate treatment, however, with the toxic form of diphtheria and its rapid development in relation to auditory function is unfavorable.