Polymorphonuclear leukocyte dysfunction in children with recurrent otitis media

Peripheral polymorphonuclear leukocyte function was studied in 102 children, age 6 months through 12 years, with persistent middle-ear effusion and recurrent acute otitis media. All of the patients were initially studied when ventilation tubes were inserted. Serous effusion was found in 19% of middle ears and mucoid effusion in 54%. Hemophilus influenzae and Staphylococcus epidermidis were the most common organisms in culture positive effusions. Depressed PMN chemotactic responsiveness was observed in 17.5% of 97 patients studied, depressed PMN bactericidal activity in 23.3% of 30 patients, and depressed PMN chemiluminescence activity in 15.8% of 19 patients. Depressed chemotactic responsiveness was found more often in patients less than 3 years of age who had their initial bout of acute otitis media prior to age one year. These children also most frequently cultured H. influenzae from their effusions. Of 30 patients whose PMNs were studied for both chemotactic and bactericidal responsiveness, four (13.3%) had a combined defect, three (10%) had only depressed bactericidal activity, and two (6.7%) had only depressed chemotaxis. Repeat PMN function studies were performed after surgery in six children and were normal in four, suggesting that leukocyte dysfunction was transient, and possibly associated with the presence of middle-ear effusion.