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Acute mastoiditis in children--our experience
P Vera-Cruz1, R R Farinha, V Calado
1Hospital de S. José, Serviço de Otorrinolaringologia, Lisbon, Portugal.
Abstract:
The incidence of acute mastoiditis and the number of complications has changed since the 1950s, despite the increasing antibiotic effectiveness. Other series concluded that the incidence of acute mastoiditis is rising in the recent years, which can be justified by the antibiotic resistance of the microorganisms and the absence of paracentesis in the treatment of acute otitis media. Our aim is to approach risk factors, clinical presentation, diagnosis and treatment of acute mastoiditis. We reviewed 62 clinical records of patients in pediatric age, observed in D. Estefania Hospital Lisbon, between January 1993 and December 1997. There was a relative homogenous distribution during the 5 years of the study period. The patient age ranged from 5 months to 14 years. They all were treated with intravenous antibiotics. The mean duration of treatment was 7.4 days. We registered 15 complications: 14 retroauricular subperiosteal abscesses and one subdural empyema. The most common isolated microorganism was Streptococcus pneumoniae. We found no statistic difference (P > 0.1) in the incidence of acute mastoiditis between the 5 years of the study.
Insights
Acute mastoiditis incidence remained stable between 1993-1997, despite antibiotic use. Streptococcus pneumoniae was the most common cause, with retroauricular abscesses being the main complication.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
Background:
- The incidence of acute mastoiditis and its complications have shown changes since the 1950s.
- Recent studies suggest a potential rise in acute mastoiditis, possibly linked to antibiotic resistance and altered acute otitis media treatment protocols.
Purpose of the Study:
- To investigate the risk factors, clinical presentation, diagnosis, and treatment of acute mastoiditis in pediatric patients.
- To analyze trends in acute mastoiditis incidence and associated complications over a five-year period.
Main Methods:
- A retrospective review of 62 pediatric patient records diagnosed with acute mastoiditis between January 1993 and December 1997.
- Analysis of patient demographics, clinical course, microbiological data, treatment regimens (intravenous antibiotics), and recorded complications.
Main Results:
- No statistically significant difference in the incidence of acute mastoiditis was observed across the five-year study period (P > 0.1).
- The most frequently isolated microorganism was Streptococcus pneumoniae.
- Fifteen complications were recorded, predominantly 14 retroauricular subperiosteal abscesses and one subdural empyema.
Conclusions:
- During the study period (1993-1997), the incidence of acute mastoiditis in pediatric patients remained consistent.
- Streptococcus pneumoniae was the primary pathogen identified, and subperiosteal abscesses were the most common complication, necessitating intravenous antibiotic treatment.