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Mastoid subperiosteal abscess
Abstract:
Subperiosteal abscess was the indication for surgery in every child with acute mastoiditis who underwent mastoidectomy at our institution since 1972. Nineteen such patients are discussed herein. Positive bacteriologic findings included Streptococcus pyogenes in three patients, Streptococcus pneumoniae in three patients, Mycobacterium tuberculosis in two patients, and enterococcus in the one patient with cholesteatoma. Cultures were more often positive for causative bacteria when taken directly from the abscess before or shortly after beginning antibiotic therapy.
Insights
Surgery for acute mastoiditis in children was indicated by subperiosteal abscess. Streptococcus pyogenes, Streptococcus pneumoniae, and Mycobacterium tuberculosis were common pathogens identified in these pediatric cases.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
- Microbiology
Background:
- Acute mastoiditis is a significant pediatric infection.
- Subperiosteal abscess necessitates surgical intervention in pediatric mastoiditis.
- Understanding causative pathogens is crucial for effective treatment.
Purpose of the Study:
- To analyze the microbiological findings in children with acute mastoiditis and subperiosteal abscess.
- To identify common bacterial and mycobacterial pathogens.
- To evaluate the optimal timing for bacterial cultures.
Main Methods:
- Retrospective review of pediatric patients undergoing mastoidectomy for acute mastoiditis since 1972.
- Analysis of surgical indications, specifically subperiosteal abscess.
- Bacteriologic culture results from abscess samples were examined.
Main Results:
- Nineteen pediatric patients with subperiosteal abscess requiring mastoidectomy were identified.
- Common pathogens included Streptococcus pyogenes, Streptococcus pneumoniae, and Mycobacterium tuberculosis.
- Cultures yielded higher positivity rates when obtained before or early in antibiotic therapy.
Conclusions:
- Subperiosteal abscess is the primary surgical indication for pediatric acute mastoiditis.
- Diverse pathogens, including Streptococcus species and M. tuberculosis, can cause this condition.
- Prompt abscess culture is vital for accurate microbiologic diagnosis in pediatric mastoiditis.