Temporal bone pathology in an active case of glue ear

A child aged 3 1/2 died from a cardiac condition after many and prolonged antibiotic courses: bilateral glue ear had been treated for the previous 18 months. Histopathology showed cholesterol granulomata in the mastoid air cells, with evidence of old hemorrhage, and of former inflammation of bone. The exudate was histiocytic with some giant cells. An 'orange spot' on the tympanic membrane was hyperaemic middle-ear mucosa, heavily infiltrated by plasma cells, lymphocytes and histiocytes. There was no evidence of hypersecretion. Some of the most abnormal areas were around the stapedial niche and the round window.

Transmission of Toxoplasma gondii across the guinea-pig placenta

6 guinea-pigs were inoculated intraperitoneally at 4-54 days of pregnancy with 60 or 100 Toxoplasma cysts in mouse-brain saline suspension. All foetuses were infected. 3 sows died on 17-19th post-inoculation day, with signs of meningo-encephalitis, and displayed focal lymphocytic inflammation and, in 2, Toxoplasma rosette formation in the cerebral hemisphere. 6 Sows previoulsy inoculated with 100-200 cysts were followed in later pregnancy: 5 of 17 foetuses were found to be infected when delivered-a further 4, and 3 carneous moles, were not examined. 4 non-pregnant sows died at 12-14 days after inoculation with 100-200 cysts, with similar clinical signs to those in the first group.

Antibody titres of 256 were found at 2½ weeks, rising to a maximum of 16 384 at 6 weeks. Levels were consistently falling by 12-14 weeks.

Transmission across the placenta could not wholly be prevented by the presence of antibody except in high titre, and the important factor was concluded to be the parasitaemia.

The strain RB is midway in virulence in guinea-pigs between strains RH and 76.

Congenital toxoplasmosis and deafness. An investigation

In conclusion, it may be said that congenital toxo-plasmosis as a cause of deafness is unlikely in man; it could not be said to be impossible. Acceptable criteria for such a diagnosis are difficult to see [Wright, 1971]. Low antibodies in the mother might be a factor in favour of transmission; high antibodies and evidence of infection during the relevant pregnancy would most likely lead to a classical case of congenital toxoplasmosis resulting in foetal death, or an infant living with many defects. Such a case would of course present little difficulty, and KELEMEN’s [1958] cases were presumably in this group. In the present experimental study no lesions were produced in the bulla or cochlea in guinea-pigs.