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Clinical experiences with acute mastoiditis--1988 through 1998
1Department of Otolaryngology-Head and Neck Surgery, College of Medicine, Korea University, Seoul.
Abstract:
The incidence of acute mastoiditis has declined dramatically during the postantibiotic era. Even so, antibiotic-resistant or unusual pathogens can still cause this disease entity. At our hospital, we documented an increase in antibiotic-resistant and atypical pathogens such as Actinomyces spp. and Mycobacterium tuberculosis. In this paper, we discuss the optimal diagnosis and treatment strategy for acute mastoiditis, and we describe our retrospective review of 13 patients with mastoiditis who were treated at our hospital from 1988 through 1998. Eight of these patients recovered following treatment with intravenous antibiotics, with or without myringotomy, and five who had complications of disease were managed surgically. Among these five, one developed chronic otitis media and one developed cholesteatoma 3 years later. For patients with acute mastoiditis, we emphasize the need to be aware of any unusual pathogens that do not respond to empiric antibiotic therapy.
Insights
Acute mastoiditis is less common but can be caused by resistant pathogens. Awareness of unusual bacteria like Actinomyces and Mycobacterium tuberculosis is crucial for effective treatment.
Area of Science:
- Otolaryngology
- Infectious Diseases
- Microbiology
Background:
- The incidence of acute mastoiditis has significantly decreased in the postantibiotic era.
- However, antibiotic-resistant and atypical pathogens remain a concern for this condition.
Observation:
- A retrospective review of 13 patients treated between 1988 and 1998 identified an increase in antibiotic-resistant and atypical pathogens.
- Specific pathogens noted include Actinomyces spp. and Mycobacterium tuberculosis.
Findings:
- Eight patients recovered with intravenous antibiotics and/or myringotomy.
- Five patients with complications required surgical management.
- Two patients who underwent surgery later developed chronic otitis media and cholesteatoma.
Implications:
- Optimal diagnosis and treatment strategies are essential for acute mastoiditis.
- Clinicians must consider unusual pathogens that may not respond to empiric antibiotic therapy.
- Vigilance for atypical pathogens is necessary even with declining overall incidence.
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