Pathogenesis Infection PCR detects the middle ear fluid, positive findings was 70% a S pneumonia, haemophalus influenzae, haemolytic streptococcus u Immunity Middle ear is a isolated immune system Inflammatory mediators Specific antibody immunologic complex Antigen may from adenoid or nasopharygeal lymphPathogenesis ◼ Infection ◼ PCR detects the middle ear fluid, positive findings was 70% ◼ S pneumonia, haemophalus influenzae, haemolytic streptocuccus ◼ Immunity ◼ Middle ear is a isolated immune system ◼ Inflammatory mediators ◼ Specific antibody, immunologic complex ◼ Antigen may from adenoid or nasopharygeal lymph