Acute mastoiditis in children: review of the current status

Spratley, Jorge; Silveira, Helena; Álvarez, Isabel Cristina Morán; Pais-Clemente, Manuel

doi:10.1016/s0165-5876(00)00406-7

Cited by 134 publications

(84 citation statements)

References 19 publications

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“…[5][6][7][8][9][10][11][12]. Each year, different numbers of cases were identified without evidence of a trend toward either increased or decreased incidence (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

“…Interestingly, several recent publications have identified a rise in the incidence of AM, which indicates a possible correlation between decreased antibiotic use and increased frequency of mastoiditis cases. 4,[6][7][8] In an attempt to investigate the relationship between antibiotic use and the incidence of AM we performed a retrospective review of children admitted with a diagnosis of AM to our institution. Our intent was both to assess the influence on AM of antibiotics prescribed for AOM immediately prior to hospitalization and to ascertain if the antibiotics prescribed corresponded to the sensitivities of the organisms being grown from cultures obtained at surgery.…”

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confidence: 99%

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The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

Rotenberg

Berkowitz³

2008

Arch Otolaryngol Head Neck Surg

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“…[5][6][7][8][9][10][11][12]. Each year, different numbers of cases were identified without evidence of a trend toward either increased or decreased incidence (Figure 1).…”

Section: Resultsmentioning

confidence: 99%

mentioning

confidence: 99%

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

Rotenberg

Berkowitz³

2008

Arch Otolaryngol Head Neck Surg

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“…Mastoiditis is a severe bacterial infection of the mastoid bone and air cell system, often requiring surgical intervention and aggressive antibiotic treatment (40). Various studies have reported GAS to be one of the leading causes of severe mastoiditis (28,40,42), and an increase in the number of GAS mastoiditis cases has occurred since administration of the heptavalent pneumococcal conjugate vaccine in the years 2001 to 2005 (40). A 5-year study of 11,311 acute OM episodes found that 3.1% were positive for GAS and that 4 of the 346 GAS acute OM cases developed into acute mastoiditis (41).…”

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confidence: 99%

Loss of the Group A Streptococcus Regulator Srv Decreases Biofilm Formation In Vivo in an Otitis Media Model of Infection

et al. 2010

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Group A Streptococcus (GAS) is a common causative agent of pharyngitis, but the role of GAS in otitis media is underappreciated. In this study, we sought to test the hypothesis that GAS colonizes the middle ear and establishes itself in localized, three-dimensional communities representative of biofilms. To test this hypothesis, the middle ears of chinchillas were infected with either a strain of GAS capable of forming biofilms in vitro (MGAS5005) or a strain deficient in biofilm formation due to the lack of the transcriptional regulator Srv (MGAS5005 ⌬srv). Infection resulted in the formation of large, macroscopic structures within the middle ears of MGAS5005-and MGAS5005 ⌬srv-infected animals. Plate counts, scanning electron microscopy, LIVE/ DEAD staining, and Gram staining revealed a difference in the distributions of MGAS5005 versus MGAS5005 ⌬srv in the infected samples. High numbers of CFU of MGAS5005 ⌬srv were isolated from the middle ear effusion, and MGAS5005 ⌬srv was found randomly distributed throughout the excised macroscopic structure. In contrast, MGAS5005 was found in densely packed microcolonies indicative of biofilms within the excised material from the middle ear. CFU levels of MGAS5005 from the effusion were significantly lower than that of MGAS5005 ⌬srv early during the course of infection. Allelic replacement of the chromosomally encoded streptococcal cysteine protease (speB) in the MGAS5005 ⌬srv background restored biofilm formation in vivo. Interestingly, our results suggest that GAS naturally forms a biofilm during otitis media but that biofilm formation is not required to establish infection following transbullar inoculation of chinchillas.

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“…S. pneumoniae and S. pyogenes are the two most virulent pathogens of the middle ear, and they are the leading causes of complications such as mastoiditis, labyrinthitis, and meningitis (15,22,23,28,38).…”

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confidence: 99%

The Binax NOW Test as a Tool for Diagnosis of Severe Acute Otitis Media and Associated Complications

Gisselsson-Solén

Bylander²,

Wilhelmsson

et al. 2007

J Clin Microbiol

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The diagnosis of acute otitis media (AOM) is often difficult, depending heavily on the experience and skills of the examiner. However, it is important to identify episodes of AOM that involve the risk of complications and to treat these episodes appropriately. The present study was performed in order to evaluate the use of a rapid antigen assay for Streptococcus pneumoniae, the Binax NOW test, as a diagnostic tool in patients with severe AOM and associated complications. The study included 70 patients with 74 episodes of AOM, 18 of them with complications. Cultures, Binax NOW tests, and a PCR assay were performed on nasopharyngeal secretions, middle ear fluid, and in some cases mastoid bone, cerebrospinal fluid, and urine. According to culture and PCR of the middle ear fluid, 30 (41%) of the episodes were caused by S. pneumoniae. The Binax NOW test was positive in 24 of these episodes (80%). It identified pneumococcal AOM independent of antibiotic treatment, and it was easily adapted to bone tissue. The test yielded sensitivity, specificity, and positive and negative predictive values for middle ear specimens of 85%, 100%, 100%, and 89%, respectively. The corresponding positive and negative values for predicting the bacterial etiology with nasopharyngeal secretions were 51% and 75%. This study showed that the Binax NOW test is a useful diagnostic tool for patients with severe AOM with or without complications.Acute purulent otitis media (AOM) is the most common bacterial infection diagnosed among children. By 3 years of age, up to 85% of all children have experienced at least one episode of AOM (40), and 15 to 20% of the children suffer from recurrent episodes (1, 7).The most frequent microbiological cause of AOM is Streptococcus pneumoniae (26 to 48%), followed by Haemophilus influenzae (15 to 41%), Moraxella catarrhalis (23 to 25%), and Streptococcus pyogenes (4 to 8%) (2,3,20,27). S. pneumoniae and S. pyogenes are the two most virulent pathogens of the middle ear, and they are the leading causes of complications such as mastoiditis, labyrinthitis, and meningitis (15,22,23,28,38).AOM is the single most common reason for prescribing antibiotics to children (12, 24). The antibiotic load and selective pressure in the youngest age groups are consequently high, and clinical problems with antibiotic resistance have emerged (5, 41). The routine use of antimicrobial drugs in AOM treatment has been reevaluated in recent years, and watchful waiting has become an alternative (34). Watchful waiting is, however, not without risk. A safer approach is to use stricter diagnostic criteria for AOM, to improve the diagnostic tools, and to treat only those patients who are the least likely to recover spontaneously.The diagnosis of AOM, especially in young children, is often difficult and inadequate (4,12,33,42). Previous studies have shown that physicians are uncertain of the diagnosis in 40% of cases (31), and general practitioners are more likely to diagnose AOM than are otorhinolaryngologists (4). Furthermore, about 49 to 88% ...

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Acute mastoiditis in children: review of the current status

Cited by 134 publications

References 19 publications

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

The Relationship Between Acute Mastoiditis and Antibiotic Use for Acute Otitis Media in Children

Loss of the Group A Streptococcus Regulator Srv Decreases Biofilm Formation In Vivo in an Otitis Media Model of Infection

The Binax NOW Test as a Tool for Diagnosis of Severe Acute Otitis Media and Associated Complications

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