Emergency presentation of coalescent mastoiditis

Since the introduction of sulfonamides in the late 1930s, coalescent mastoiditis is an uncommon complication of otitis media. Swelling, erythema, and tenderness over the mastoid area with associated anterior displacement of the auricle are classic signs and symptoms of coalescent mastoiditis with formation of a subperiosteal abscess. Early recognition of this entity is essential to prevent its complications. Prompt otolaryngologic consultation is indicated and inpatient antibiotic therapy should be begun. Surgical treatment is also needed and may obviate further complications.