Tularemia of the middle ear.

We report the case of a 10-year-old boy with prolonged fever who was found to have tularemia of the middle ear. Otolaryngologic cases including oropharyngeal and glandular or ulceroglandular forms of the head and neck region are estimated to account for 12% of all tularemia cases, but to date we have not seen a report of tularemia in the middle ear. The possibility of tularemia may not occur to a physician because of the wide variation of clinical manifestations.

Xylitol administered only during respiratory infections failed to prevent acute otitis media.

Objective: As regular administration of xylitol had been effective in preventing acute otitis media (AOM) in children, we tested whether xylitol administered only at times of acute respiratory infection (ARI) reduces the occurrence of AOM.

Methods: Healthy children (N = 1277) were recruited from child care centers and randomized after screening with tympanometry to receive either control mixture (n = 212), xylitol mixture (n = 212), control chewing gum (n = 280), xylitol chewing gum (n = 286), or xylitol lozenges (n = 287) during an ARI. The trial was randomized and double blinded within the mixture and chewing gum groups.