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Acute mastoiditis: increase in the incidence and complications
M Bartolomé Benito1, B Pérez Gorricho
1Niño Jesus University Children Hospital, Madrid, Spain. mbartolomeb@terra.es
Summary
Acute mastoiditis cases have doubled since 1999, with surgical treatments increasing significantly. This trend suggests rising antibiotic resistance and the need for advanced interventions like tympanocentesis for effective otitis media complication management.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Acute mastoiditis, a severe complication of acute otitis media, is typically managed with antibiotics and myringotomy.
- Recent observations suggest an increasing frequency and complexity of otic infectious pathologies.
Purpose of the Study:
- To investigate the trend in acute mastoiditis cases over a 10-year period.
- To analyze the changing bacteriology, treatment modalities, and outcomes.
- To identify potential causes for observed increases in complicated cases.
Main Methods:
- Retrospective review of 215 acute mastoiditis cases (1996-2005) at a children's hospital.
- Analysis of patient demographics, clinical presentation, bacteriology, and treatment approaches.
- Comparison of data from earlier and later periods within the study timeframe.
Main Results:
- A doubling of annual mastoiditis cases since 1999, with a tripling by 2005.
- A significant rise in surgical treatment rates, from 4.3% to 70% by 2005.
- High prevalence of prior antibiotic use (80%) and detection of Streptococcus pneumoniae (28.57%) and Staphylococcus aureus (16.32%).
Conclusions:
- A progressive increase in acute mastoiditis incidence and surgical interventions is evident.
- Rising antibiotic resistance may necessitate more frequent tympanocentesis and surgical treatments.
- Future management may require more aggressive diagnostic and therapeutic strategies for resistant infections.
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