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Changes in acute mastoiditis in a single pediatric tertiary medical center: our experience during 2008-2009 compared

Achyia Z Amir1, Ronen Pomp, Jacob Amir

  • 1From the Department of Pediatrics B, Schneider Children's Medical Center of Israel , Petach Tikva.

Scandinavian Journal of Infectious Diseases
|November 16, 2013
PubMed

Insights

Acute mastoiditis in children shows evolving bacterial causes, with Streptococcus pyogenes increasing significantly. Some cases develop without prior ear infection symptoms, highlighting diagnostic challenges.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Otolaryngology

Background:

  • Acute mastoiditis is a serious complication of acute otitis media.
  • Long-term trends in causative pathogens and clinical presentation are not well-documented.

Purpose of the Study:

  • To analyze clinical and bacteriological changes in pediatric acute mastoiditis over 25 years.
  • To identify shifts in common pathogens and clinical manifestations.

Main Methods:

  • Retrospective review of medical records of children hospitalized with mastoiditis (2008-2009).
  • Comparison with historical data from 1983-2007 from the same center.
  • Bacteriological culture analysis and clinical symptom assessment.

Main Results:

  • 134 children (143 episodes) with acute mastoiditis were identified in 2008-2009.
  • Streptococcus pneumoniae (32%), Streptococcus pyogenes (20%), Pseudomonas aeruginosa (13%), and Haemophilus influenzae (10%) were common isolates.
  • The incidence of S. pyogenes increased from ~5% to 20% between 1990-2005, with a rise in annual cases.
  • 22% of cases lacked preceding clinical symptoms of ear infection.

Conclusions:

  • Streptococcus pyogenes has emerged as a significant pathogen in pediatric acute mastoiditis.
  • Acute mastoiditis can occur without preceding symptoms in a notable percentage of cases.
  • Longitudinal data reveals evolving epidemiology and clinical presentation of this condition.
Abstract

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