Complications of Mastoiditis in Children at the Onset of a New Millennium

Abstract

The aim of the present study was to review our recent experience in the diagnosis and treatment of acute mastoiditis and its complications in a single tertiary-care, university-affiliated pediatric center. Ninety-eight children with 101 episodes of acute mastoiditis were included in the study. The mean interval from onset of illness to mastoiditis was 4.5 days. Ear cultures most often grew Streptococcus pneumoniae and Pseudomonas aeruginosa (23.7% each). Complications occurred in 15.8% of episodes. The only factor differentiating children with and without complications was white blood cell count. These findings indicate that acute mastoiditis not only is a complication of prolonged infection of the middle ear, but may also present as an acute infection of the mastoid bone that can progress within 48 hours. The complication rate remains high, and antibiotic treatment at the onset of symptoms does not prevent complications. A high white blood cell count on admission may serve as a predictive factor of complicated cases.

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

“…[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).…”

Complicações Intracranianas de Otite Média: A Experiência de 7 Anos do Hospital de Braga

“…É recomendada que seja realizada punção lombar apenas após exame de imagem. 8 O tratamento da meningite associado a OMA baseia-se no tratamento médico, associado a miringotomia. Nos casos em que esta se associa a OMC, na maioria dos casos deve ser realizada ampla mastoidectomia com exploração de provável deiscência na dura e sua reparação.…”

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

“…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.…”