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Acute mastoiditis in children: a retrospective study of 188 patients

S Quesnel1, M Nguyen, S Pierrot

  • 1AP-HP, Necker Hospital, ENT Department, Paris, France. steph.quesnel@gmail.com

International Journal of Pediatric Otorhinolaryngology
|October 26, 2010
PubMed

Insights

This study defines acute mastoiditis (AM) characteristics in children, finding Streptococcus pneumoniae as the most common cause. Optimized treatment involves targeted antibiotics and mastoidectomy when necessary, avoiding routine surgery.

Area of Science:

  • Pediatric Otolaryngology
  • Infectious Diseases
  • Microbiology

Background:

  • Acute mastoiditis (AM) is a significant pediatric ear infection requiring careful management.
  • Understanding the clinical and bacteriological profiles of AM is crucial for effective treatment strategies.

Purpose of the Study:

  • To characterize the clinical and bacteriological features of acute mastoiditis in children.
  • To optimize the diagnostic work-up and treatment protocols for pediatric AM.

Main Methods:

  • Retrospective analysis of 188 children diagnosed with AM over a 7-year period.
  • Inclusion criteria: children aged 3 months to 15 years presenting to a pediatric ENT emergency center.
  • Data collection included clinical presentation, microbiological findings, treatment, and outcomes.

Main Results:

  • Streptococcus pneumoniae was the most frequent pathogen (51%), followed by Streptococcus pyogenes (11.5%).
  • 33% of microbiological samples were negative; anaerobes and Gram-negative bacteria were associated with surgical failures.
  • 36.2% of patients required surgery; recurrences were more common with S. pneumoniae AM.
  • Lateral sinus thrombosis was the primary complication (3.2%).

Conclusions:

  • A standardized management protocol for pediatric AM was developed, emphasizing non-systematic surgery.
  • Surgical intervention, when indicated, should include mastoidectomy.
  • Treatment involves broad-spectrum intravenous antibiotics, adjusted based on microbiological results, with mastoidectomy considered if infection persists after 48 hours.
Abstract

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