著者
末武 光子 入間田 美保子 高橋 辰 沖津 尚弘 大山 健二
出版者
Japan Otological Society
雑誌
Otology Japan (ISSN:09172025)
巻号頁・発行日
vol.10, no.2, pp.89-94, 2000-05-25 (Released:2011-06-17)
参考文献数
5
被引用文献数
5

Mucoud otitis is known to be caused by mucoid typeStreptococcus pneumoniae, and the most of them are serotype 3. As the result of the development of antibiotics this bacteria has once been regarded as an unimportant pathogen. However recently, there are found severe cases in which this pathogen is responsible.During the period from January 1998 to July 1999, we have treated 25 cases in which the mucoid typeStreptococcus pneumoniaewas isolated.Based on these experiences, we summarized the current status of the mucoid otitis media as follows.1. The distribution of patients suffering from mucoid otitis medid ranged infants to elderly people. 2. The patients presented with symptomes, such as severe earache, headache, high fever, profuse otorrhea, aggravation of sensorineural hearing. 3. The relief of the symptomes is usually better and earlier when penicillin was selected as a first choice, while when cephem antibiotics were selected, healing of the otitis media tend to be delayed. 4. As 13 out of 14 strains isolated in 1999 were found to be penicillin-insensitiveStreptococcus pneumoniae (PISP) withpbp2xgene, it is conceivable that the resistance of this pathogen against cephem is under a rapid progress, probably due to abuse cephem in the past in this country. 5. The antibiotics of the first choice against mucoid otitis media is penicillin. If the pathogen would acquire penicillin resistance, treatment of mucoid otitis media may become as difficult as it used be in old days of preantibiotics. We should pay enough attention to this disease as an important reemerging infectious disease in the otolaryngologic field.

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若い先生方はあまりピンとこないかもしれませんが、2010年頃肺炎球菌ワクチンが導入されるまではこのムコーズス中耳炎は劇症化で脳障害が残ったり内耳障害から人工内耳になる症例もありました。ワクチン効果をキャンセルしてしまう不適切なステロイドは本当に危険です。https://t.co/OaibtpeenY https://t.co/8ZrEcP9NNc
(参考メモ) 「#ムコーズス中耳炎 は #ムコイド型肺炎球菌 を起炎菌とする #急性中耳炎 である。抗菌薬のなかった時代には、全急性中耳炎の20%を占め、70から90%の症例が急性乳様突起炎を併発し、約10%が頭蓋内合併症で死亡したと報告されている」(東北労災病院耳鼻咽喉科) https://t.co/z1PQF4ul3t

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