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Pneumococcal mastoiditis in children

S L Kaplan1, E O Mason, E R Wald

  • 1Pediatric Infectious Disease Section of ¿Baylor College of Medicine, Houston, Texas 77030-2399, USA. skaplan@bcm.tmc.edu

Pediatrics
|October 4, 2000
PubMed

Insights

Antibiotic resistance in Streptococcus pneumoniae did not increase the frequency of childhood mastoiditis. However, serogroup 19 is the leading cause of pneumococcal mastoiditis, even with rising resistance rates.

Area of Science:

  • Pediatric infectious diseases
  • Otolaryngology
  • Microbiology

Background:

  • Mastoiditis is a serious complication of otitis media.
  • Streptococcus pneumoniae is a common pathogen causing mastoiditis in children.
  • Increasing antibiotic resistance in S. pneumoniae raises concerns about treatment efficacy.

Purpose of the Study:

  • To assess the impact of antibiotic resistance on Streptococcus pneumoniae-related mastoiditis in children.
  • To analyze the frequency, clinical presentation, and outcomes of pneumococcal mastoiditis.
  • To identify prevalent serogroups and serotypes of antibiotic-resistant S. pneumoniae causing mastoiditis.

Main Methods:

  • Retrospective review of medical records of children diagnosed with S. pneumoniae mastoiditis.
  • Data collected from 8 children's hospitals in the United States between September 1993 and December 1998.
  • Analysis included patient demographics, clinical features, management, and outcomes, alongside antimicrobial susceptibility testing of isolates.

Main Results:

  • Thirty-four cases of pneumococcal mastoiditis were identified, predominantly in children under 2 years old.
  • Subperiosteal abscess occurred in 37% of cases; mastoid abnormalities were common on CT scans.
  • Despite rising penicillin resistance in S. pneumoniae, the annual incidence of mastoiditis remained stable. Serogroup 19 was the most frequent isolate.
  • No significant differences in clinical features or management were observed between children with penicillin-susceptible and non-susceptible isolates.

Conclusions:

  • Pneumococcal mastoiditis primarily affects infants and young children, often without a history of recurrent otitis media.
  • The incidence of S. pneumoniae mastoiditis has not increased despite growing antibiotic resistance.
  • Serogroup 19 is the predominant serogroup associated with pneumococcal mastoiditis.
Abstract

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