Much more work is needed on direct ear isolates from patients with acute and chronic otitis to better define the broadfield microbiologic flora. Factors such as bacterial-viral and viral-viral synergism need to be evaluated. Also, with respect to otitis media, understanding of local defense mechanisms (secretory IgA system) has only just begun. Systemic immunologic competence and the multiple host factors all need to be evaluated prior to understanding the pathogenesis of otitis media.
ASJC Scopus subject areas