Acute mastoiditis in infants and children

Area of Science:

• Pediatrics
• Otolaryngology
• Infectious Diseases

Background:

• Acute mastoiditis is an infection of the mastoid bone, often a complication of middle ear infections.
• It primarily affects infants and young children, presenting with specific clinical signs.

Purpose of the Study:

• To analyze the clinical characteristics, diagnostic methods, and complications of acute mastoiditis in a pediatric population over a 25-year period.
• To assess trends in the frequency of serious complications associated with acute mastoiditis.

Main Methods:

• Retrospective review of 57 pediatric cases of acute mastoiditis diagnosed over 25 years.
• Clinical examination, tympanic membrane assessment, and mastoid roentgenograms were utilized.
• Bacterial cultures were performed to identify causative agents.

Main Results:

• Common symptoms included tympanic membrane abnormalities, fever, and localized swelling.
• Infants (<1 year) showed swelling above the ear, while older children had mastoid process swelling.
• Osteomyelitis was identified in 9 patients via roentgenograms.
• Common pathogens were Streptococcus pneumoniae, Staphylococcus aureus, and Streptococcus pyogenes.
• Serious complications occurred in 53% of patients, including one death from meningitis.

Conclusions:

• Acute mastoiditis in children presents with varied signs depending on age.
• Prompt diagnosis using imaging and cultures is crucial for identifying bacterial etiology and complications.
• The incidence of severe complications from acute mastoiditis has not diminished over the last three decades, underscoring the need for continued vigilance.