Bacteriology in relation to clinical findings and treatment of acute mastoiditis in children

Laulajainen‐Hongisto, Anu; Saat, Riste; Lempinen, Laura; Markkola, Annamari; Aarnisalo, Antti A.; Jero, Jussi

doi:10.1016/j.ijporl.2014.09.007

Cited by 41 publications

(28 citation statements)

References 32 publications

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“…The bacterial etiology of complicated OM in adults seems to differ from that of uncomplicated AOM, which is quite similar to the case in children [19,25,26] . We found that the typical pathogens in AOM, namely, H. influenzae and M. catarrhalis, are uncommon in both children and adults with complicated OM.…”

Section: Discussionsupporting

confidence: 51%

“…The following criteria were used for AOM: symptoms of acute (≤14 days) illness (fever, earache, or respiratory symptoms) and findings of middle ear effusion with signs of infection (bulging, redness, or abnormal mobility) of the tympanic membrane (TM) upon otomicroscopy or recent onset of otorrhea. The following criteria were used for AM: AOM with at least two of the following symptoms: retroauricular redness, swelling, pain, or fluctuation, protrusion of the pinna, an abscess in the external auditory canal (EAC), and/or purulent secretion or acute infection in the mastoid process following mastoidectomy [19] .…”

Section: Participants and Datamentioning

confidence: 99%

“…S. pyogenes has been reported to cause a severe, complicated clinical profile of AOM in children [17,18] . AOM and its complications, however, differ in children and adults, with most studies focusing on children [19,20] .…”

Section: Introductionmentioning

confidence: 99%

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Severe Acute Otitis Media and Acute Mastoiditis in Adults

Hongisto

Jero

Markkola³

et al. 2016

Int Adv Otol

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OBJECTIVE:To evaluate and compare clinical and microbiological findings in adults hospitalized for acute otitis media (AOM) or mastoid infections (acute or latent). MATERIALS and METHODS:We retrospectively reviewed the medical records of all adults (≥17 years old) hospitalized (between 2003 and 2012) at a tertiary referral center for acute mastoid infections or AOM not responding to outpatient medical treatment. RESULTS:Of the 160 patients in the study sample, 19% had an infection caused by S. pyogenes, 14% by S. pneumoniae, and 11% by P. aeruginosa. AOM was the most common infection (38%), whereas 33% had acute mastoiditis (AM), 18% had latent mastoiditis (LM), and 13% AM of a chronically infected ear (AMc). In contrast to the other infections, P. aeruginosa (30%) and S. aureus (25%) were most common in AMc. Otorrhea (83%), tympanic membrane perforation (57%), and hearing problems (83%) were common in S. pyogenes infections. Patients with S. pneumoniae had longer lengths of hospitalization than those with other bacterial infections (7 vs. 4 days). Otorrhea (94%) and retroauricular symptoms were more common in P. aeruginosa infections. Hearing symptoms were common (67%) but fever (32%) and retroauricular symptoms were uncommon in AOM. Fever (44%) and mastoid tenderness (65%) were common in AM. Patients with LM underwent the most mastoidectomies (54%). Prior medical conditions, retroauricular symptoms, otorrhea (90%), and post-infection problems were common in AMc. CONCLUSION:The bacteriological etiology of hospitalized AOM more closely resembled those of LM and AM than that of AMc. Adults hospitalized for AOM or AM required fewer mastoidectomies than those hospitalized for LM or AMc.

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Section: Discussionsupporting

confidence: 51%

Section: Participants and Datamentioning

confidence: 99%

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Severe Acute Otitis Media and Acute Mastoiditis in Adults

Hongisto

Jero

Markkola³

et al. 2016

Int Adv Otol

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“…In most studies, this percentage was somewhat markedly higher and exceeded 60% [17,22,23,31]. Like reported by other authors, the most common pathogenic isolate was S. pneumoniae [5,14,15,17,19,23,35,37].…”

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confidence: 48%

Acute mastoiditis in children population

Zonenberg¹,

Hassmann‐Poznańska

Skotnicka

et al. 2019

Pol Otorhino Rev

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Aim: The aim of the study was to perform a retrospective analysis of the medical documentation of patients treated for acute mastoiditis (AM) at the Department of Pediatric Otolaryngology in Bialystok and to review the available literature on this subject so as to determine optimum AM management principles. Material and methods:A retrospective analysis of 40 patients treated for AM in 2001-2017 was performed. Patient enrollment was based on the AM diagnostic criteria established by Anthonsen et al [15]. results:The mean age of the subjects was 46 months, with 37% of children being less than 2 years old. No previous episodes of acute otitis media (AOM) had been reported in 2/3 of cases. Prior to hospital admission, antibiotics had been administered to 69% of patients. In laboratory investigations, 95% of patients presented with elevated inflammation markers (CRP, leukocytosis), with the values of these markers being higher in patients qualified for surgery. Indications for computed tomography (CT) scans included lack of improvement following 48 hours of conservative treatment or the presence of symptoms of subperiosteal abscesses. CT scans were performed in 35% of patients. Conservative treatment alone was administered to 24 patients (60%); this included myringotomy with/without ventilation tube insertion and intravenous antibiotic therapy. Ceftriaxone was the most commonly used antibiotic, being administered to 75% of patients. Mastoidectomy was required in 16 patients. The most common indication (30%) for mastoidectomy consisted in the presence of subperiosteal abscess. conclusion:In non-complicated cases of AM, there is no need for routine performance of CT scans; myringotomy with or without insertion of ventilation drains should be performed and empirical intravenous antibiotic therapy should be started.In the presence of a subperiosteal abscess, a contrast-enhanced CT scan and mastoidectomy are recommended. Deterioration of patient's condition or lack of improvement after 48 hours of conservative treatment requires a CT scan being performed and the decision on potential mastoidectomy being made on the basis of the scan. Keywords:acute mastoiditis, children, acute otitis media, treatment streszczenie: cel: Celem pracy była analiza retrospektywna dokumentacji chorych leczonych z powodu ostrego zapalenia wyrostka sutkowatego (OZWS) w Klinice Otolaryngologii Dziecięcej w Białymstoku, jak również dostępnego piśmiennictwa na ten temat, w celu określenia optymalnych zasad postępowania w OZWS. Materiał i metody:Analiza retrospektywna 40 pacjentów leczonych z powodu OZWS w latach 2001-2017. Kryteria włączenia pacjentów przyjęto za Anthonsen i wsp.[15]. wyniki: Średni wiek badanych wynosił 46 miesięcy, 37% dzieci miało mniej niż 2 lata. 2/3 przypadków nie było poprzedzonych wcześniejszymi epizodami OMA. 69% chorych otrzymywało antybiotyk przed przyjęciem do szpitala. W badaniach laboratoryjnych u 95% chorych stwierdzono podwyższone wykładniki stanu zapalnego (CRP, leukocytoza), ich wartość była wyższa wśród chorych zak...

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“…Presentation in the mastoid is uncommon and may be misdiagnosed as a more common condition, such as infectious mastoiditis, due to overlapping clinical and imaging characteristics. The similarities are notable: each may present on imaging as an isolated enhancing lesion arising from the mastoid with soft tissue involvement and bony destruction, involvement of the surrounding venous sinus may result in thrombosis, and otalgia or diplopia may be present in either condition [8, 11, 40-42]. Clinical examination and chemical markers may be further limited in their ability to differentiate the 2 conditions.…”

Section: Discussionmentioning

confidence: 99%

Cranial Rhabdomyosarcoma Masquerading as Infectious Mastoiditis: Case Report and Literature Review

et al. 2018

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Background: Rhabdomyosarcoma originating in the mastoid is rare and may be misdiagnosed as an infectious mastoiditis due to overlapping clinical and imaging features. We aimed to identify distinguishing characteristics to facilitate earlier diagnosis and treatment. Method: Here we describe a case report and a systematic review of 23 reports describing previous cases of mastoid rhabdomyosarcoma. We compare these patients to a systematic review of patients with infectious mastoiditis and identify distinguishing clinical features. Results: A total of 43 patients with rhabdomyosarcoma of the mastoid were identified and compared with patients with mastoiditis. Rhabdomyosarcoma patients were more likely to present with a mass (86%) or cranial nerve dysfunction (83.7%), while mastoiditis patients were more likely to have fever (72.4%), pain (48.2%), and present at a younger age (4.4 vs. 6.1 years). The average lifespan with rhabdomyosarcoma of the mastoid was 7.1 months after diagnosis, with 41.7% of patients alive at the time of report. Conclusions: Based on abstracted and aggregated information, we identified unique features observed more frequently in each of rhabdomyosarcoma and mastoiditis. These predictive features allow for the differentiation of each diagnosis and avoid the delay of proper treatment.

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Bacteriology in relation to clinical findings and treatment of acute mastoiditis in children

Cited by 41 publications

References 32 publications

Severe Acute Otitis Media and Acute Mastoiditis in Adults

Severe Acute Otitis Media and Acute Mastoiditis in Adults

Acute mastoiditis in children population

Cranial Rhabdomyosarcoma Masquerading as Infectious Mastoiditis: Case Report and Literature Review

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