Role of atypical pathogens in infectious and inflammatory ENT diseases

Introduction. Inflammatory ear, nose, and throat (ENT) diseases account for a significant proportion in the respiratory disease profile. The causative agents of these diseases may include atypical infections along with other viral and bacterial agents.

Aim. To determine the seasonal incidence of Chlamidia pneumoniae and Mycoplasma pneumoniae infections in acute respiratory infection (ARI) outpatients with otolaryngological manifestations; to evaluate the most common symptoms to establish a relationship between clinical symptoms and laboratory findings of patients.

Materials and methods. 284 acute respiratory infection (ARI) patients aged 3 to 17 years underwent routine examination of ENT and lower airways, PCR assay for the detection of C. pneumoniae and M. pneumoniae in epithelial cell scrapings obtained from the nasopharynx and oropharynx, chlamydia and mycoplasma IgA/IgG/IgM ELISA, bacteriological analysis. Statistical data processing was conducted.

Results. Acute sinusitis (82.4%) and pharyngitis (21.8%) were the most common clinical manifestations of respiratory mycoplasmosis and chlamydia in patients. M. pneumoniae IgM positivity was found in 53.3% of patients aged 3 to 6 years, similar data were obtained regarding C. pneumoniae. The frequency of positivity rates for C. pneumoniae IgM, IgG and IgA and M. pneumoniae IgM was found to be significantly higher in autumn as compared to other seasons (p < 0.05).

Conclusions. Respiratory mycoplasmosis is common in preschool and primary school children in the autumn-winter period. ENT atypical microflora manifests itself as acute rhinosinusitis, in which mycoplasma-chlamydial infection is detected in 31.7% of cases. The classic clinical presentations of respiratory mycoplasmosis include productive cough along with nasal breathing difficulty and discharge from the nasal cavity.

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