Fungi from otitis media of agricultural field workers

Twenty four fungi were isolated from ear wax or otitis media of agricultural field workers, of which 18 are being reported for the first time from India. Direct observation, revealed the presence of hyphal fragments, spores of Alternaria, Bipolaris, conidial head of Aspergillus, smut teliospores and pollen. Spores of only four fungi, Alternaria humicola, Aspergillus niveus, Bipolaris spicifera and Fusarium moniliforme germinated in otitis media at 37 ° C, and their germination was affected by relative humidity. Alternaria humicola and Aspergillus niveus appeared to be the causative agents of otomycosis, and otitis media is fungistatic in nature.     

Ear wax and otitis media in children.

A study was designed to find the prevalence of ear wax in children aged 3 to 10 years and to test the belief that large amounts of wax are unlikely to be seen when otitis media is present. Roughly a quarter of the children had appreciable amounts of wax, and there was a gradual decline in prevalence with age. The amount of ear wax appeared to decrease when otitis media was present. The results did not support removing wax when assessing children''s ears in general practice.     

Bacterial otitis media: current vaccine development strategies

Otitis media is the most common reason for children less than 5 years of age to visit a medical practitioner. Whilst the disease rarely results in death, there is significant associated morbidity. The most common complication is loss of hearing at a critical stage of the development of speech, language and cognitive abilities in children. The cause and pathogenesis of otitis media is multifactorial. Among the contributing factors, the single most important are viral and bacterial infections. Infection with respiratory syncytial virus, influenza viruses, para-influenza viruses, enteroviruses and adenovirus are most commonly associated with acute and chronic otitis media. Streptococcus pneumoniae, non-typeable Haemophilus influenzae and Moraxella catarrhalis are the most commonly isolated bacteria from the middle ears of children with otitis media. Treatment of otitis media has largely relied on the administration of antimicrobials and surgical intervention. However, attention has recently focused on the development of a vaccine. For a vaccine to be effective against bacterial otitis media, it must, at the very least, contain antigens that induce a protective immune response in the middle ear against the three most common infecting bacteria. Whilst over the past decade there has been significant progress in the development of vaccines against invasive S. pneumoniae disease, these vaccines are less efficacious for otitis media. The search for candidate vaccine antigens for non-typeable H. influenzae are well advanced whilst less progress has been made for M. catarrhalis. No human studies have been conducted for non-typeable H. influenzae or M. catarrhalis and the concept of a tribacterial vaccine remains to be tested in animal models. Only when vaccine antigens are determined and an understanding of the immune responses induced in the middle ear by infection and immunization is gained will the formulation of a tribacterial vaccine against otitis media be possible.