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Clinical presentation of acute mastoiditis in children
1Department of Pediatrics, Mackay Memorial Hospital, Taipei, Taiwan, ROC.
Insights
Acute mastoiditis in children, though uncommon, requires prompt diagnosis and treatment. Early intervention is crucial to prevent serious complications like hearing loss and meningitis.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
Background:
- Acute mastoiditis is an uncommon but potentially severe complication of otitis media.
- Prompt diagnosis and management are essential to prevent sequelae.
Purpose of the Study:
- To review the clinical characteristics, causative organisms, management, and outcomes of acute mastoiditis in children.
- To highlight the importance of early diagnosis and intervention.
Main Methods:
- Retrospective chart review of 19 children with 21 episodes of acute mastoiditis treated between 1989 and 1998.
- Diagnosis confirmed by physical, radiological, and surgical findings.
Main Results:
- Peak incidence observed at 4 years old.
- Common symptoms included postauricular pain (90.5%) and fever (81%).
- Streptococcus pneumoniae (38.1%) and Pseudomonas aeruginosa (23.8%) were the most frequent pathogens. Underlying conditions like leukemia were present in 38.6% of patients.
- Hearing loss (31.6%) and meningitis (21.1%) were the most common complications. Two patients developed subperiosteal abscesses, and one had a brain abscess.
Conclusions:
- Acute mastoiditis necessitates early diagnosis and management to mitigate severe complications.
- Effective treatment involves intravenous antibiotics, with some cases requiring surgical drainage.
Abstract:
Nineteen children with 21 episodes of acute mastoiditis were treated in our hospital from 1989 to 1998. The diagnosis was based on physical, radiologic, and surgical findings. The affected children were aged from 1 year old to 17 years old, with the peak incidence at 4 years old (23.8%). Postauricular pain (90.5%) and fever (81%) were the most common harbingers of incipient acute mastoiditis. Streptococcus pneumoniae (38.1%) was the most common organism isolated followed by Pseudomonas aeruginosa (23.8%). Underlying diseases such as leukemia and myeloid metaplasia were found in 38.6% of patients. All of the patients were initially treated with intravenous antibiotics during hospitalization. Six patients were managed with an adjunctive drainage procedure such as myringotomy or mastoidectomy. The most common complication of acute mastoiditis was hearing loss (31.6%); the second was meningitis (21.1%). Subperiosteal abscess was found in two patients and brain abscess in one. Although acute mastoiditis is an uncommon condition, early diagnosis and management are necessary to prevent more serious complications.