Læknablaðið - 15.04.1999, Blaðsíða 12

292
LÆKNABLAÐIÐ 1999; 85
Hlustarbólga eftir sundnámskeið
Gísli Baldursson', Gunnar H. Gíslason’, Hannes Petersen2
Baldursson G, Gíslason GH, Petersen H
External otitis in school children after an inten-
sive swimming course
Læknablaðið 1999; 85: 292-5
Objective: This study reports an outbrake of exter-
nal otitis in boarding school children after they had
participated in an intensive swimming course. The
infective agent isolated was P. aeruginosa. The ques-
tion is raised whether the outbrake was caused by
water contaminated by bacteria or intensive bathing.
Matcrial and methods: Twenty-seven children from
a rural boarding school, aged 10 to 14 years partici-
pated in an obligatory swimming course for two
weeks. As the outbrake became evident all the child-
ren were examined by two doctors with an otomicro-
scope. Bacterial culture was taken from the external
acoustic meatus (EAM) on both sides and a tympa-
nogram was performed on all. Subjective evaluation
of symptoms was achieved by using a questionnaire.
Eight weeks after the swimming course ended all
participants were investigated again with an ear
microscope and control bacterial culture was taken
from the EAM for appreciation of the outcome.
Results: Seventeen (63%) of the 27 children had
symptoms of external otitis on the first visit. Micro-
scopic investigation of those infected revealed seven
(41.2%) children with mild, four (23.5%) with mode-
rate and six (35.3%) with severe inflammation of the
EAM. Of those children affected 12 (70.6%) had in-
fection in both ears. P. aeruginosa was isolated from
11 (64.7%)_of those affected and from two of those
who had no symptoms. The mean onset of symptoms
Frá 'Heilsugæslustöðinni á Egilsstöðum, "háls-, nef- og
eyrnadeild Sjúkrahúss Reykjavíkur. Fyrirspurnir, bréfa-
skipti: Hannes Petersen háls-, nef- og eyrnadeild Sjúkra-
húss Reykjavíkur, Fossvogi, 108 Reykjavík. Sími: 525 1370.
Bréfsími: 525 1383. Netfang: hpet@shr.is
Lykilorð: hlustarbólga, sundlaug, Pseudomonas aerugin-
osa.
was 2.1 days (standard error 0.5) after the swimming
course had ended. The mean time for symptom relief
was 11.4 days (standard error 2.2).
Conclusions: Intensive swimming courses in pools
where the quality of the water is checked sporadically
is not advised. If intensive swimming courses are
necessary the concentration of chlorine should be
carefully monitored as well as checked for growth of
both Cloriform bacteria and P. aeruginosa.
Keywords: otitis externa, Pseudomonas aeruginosa,
swimming pool.
Ágrip
Tilgangur: Tilgangur rannsóknarinnar var
að lýsa faraldri hlustarbólgutilfella sem stafaði
af P. aeruginosa í kjölfar sundnámskeiðs í
heimavistarskóla.
Efniviður og aðferðir: Tuttugu og sjö börn
á aldrinum 10-14 ára, nemendur í heimavistar-
skóla á Austurlandi tóku þátt í sundnámskeiði
sem stóð í tvær vikur. Börnin fóru í sund fjór-
um sinnum á dag (mánudag-föstudag) á
tveggja vikna tímabili. Þegar ljóst varð að til-
fellum hlustarbólgu fór fjölgandi meðal þeirra
voru öll börnin skoðuð af tveimur læknum með
eymarsmásjá, einnig var gerð hljóðhols- (þrýst-
ings) mæling á miðeyrum. Bakteríuræktanir
voru teknar úr hlust báðum megin.
Niðurstöður: Alls fengu 17 (63%) af börn-
unum einkenni hlustarbólgu meðan á sund-
námskeiðinu stóð eða strax á eftir. Skoðun með
eyrnasmásjá sýndi að sjö þeirra höfðu væg
bólgueinkenni, fjögur millistigs en sex höfðu
miklar bólgubreytingar í hlustargangi. Tólf
(70,6%) þessara barna höfðu bólgubreytingar
báðum megin. P. aeruginosa ræktaðist frá 11
(64,7%) þeirra sem höfðu einkenni en tveimur
sem höfðu engin einkenni. Einkenni byrjuðu að
meðaltali 2,1 degi (staðalskekkja 0,5) eftir að