MOST AUTHORITIES agree that more than 50% of the cases of acute otitis media are caused by viruses but it has been very hard to isolate them. Most attempts have failed.
Nonbacterial Acute Otitis Media
Merifield et al1 studied 23 cases of bullous myringitis, ten of which developed a frank hemorrhagic appearance of the blebs. The remaining 13 had blebs containing clear or yellowish fluid. Since several workers2-4 have been able to recover the Eaton agent (Mycoplasma peripneumoniae) from these cases this organism was searched for especially. None were found. Complement fixation tests were done for 21 other common viral organisms, these were also negative. Almost all cases cleared spontaneously in less than two weeks, one case developed persistent mucoid otitis media and required bilateral myringotomy and adenotonsillectomy.These virus cases usually have intense pain for a short while, very little hearing loss, and are highly contagious, usually
Dysart B. Otitis Media and Complications. Arch Otolaryngol. 1967;86(4):472–475. doi:10.1001/archotol.1967.00760050474024
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