Sensori-neural hearing loss in acute otitis media due to beta-hemolytic streptococcus successfully treated with penicillin and prednisone.

This article reports a case of a 21-year-old woman with acute otitis media with effusion secondary to a virulent group A beta-hemolytic streptococcus infection that led to rapidly deteriorating hearing in an only hearing ear. This deterioration continued despite middle ear ventilation and high-dose intravenous cefazolin and subsequent high-dose aqueous penicillin. The addition of prednisone to her therapeutic regimen led to rapid hearing improvement and decrease in effusion production. A historical perspective on the use of steroids in treating otitis media and several theories for this reversal in clinical course are presented.