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Acute mastoiditis in children: a 12-year retrospective study
E H Harley1, T Sdralis, R G Berkowitz
1Department of Otolaryngology, Royal Children's Hospital, Melbourne, Australia.
Summary
Acute mastoiditis in children often presents as the first sign of otitis media. Persistent pain and fever indicate this serious ear infection, treatable with antibiotics and drainage.
Area of Science:
- Otolaryngology
- Pediatric Infectious Diseases
Background:
- Acute mastoiditis is a complication of otitis media, primarily affecting children.
- Early identification and management are crucial to prevent further complications.
Purpose of the Study:
- To review the clinical experience with acute mastoiditis over a 12-year period.
- To identify key indicators and evaluate treatment outcomes for pediatric acute mastoiditis.
Main Methods:
- Retrospective study of 58 pediatric cases (3 months to 15 years).
- Analysis of clinical presentation, causative organisms, and treatment modalities.
- Comparison of surgical interventions including myringotomy and mastoidectomy.
Main Results:
- Acute mastoiditis was the initial manifestation of otitis media in 54% of cases.
- Prolonged pain and fever (median 4 days) were significant indicators.
- Streptococcus pneumoniae was the most common pathogen.
- No significant difference in cure rates between myringotomy and mastoidectomy.
Conclusions:
- Acute mastoiditis predominantly affects young children and can be the first sign of ear disease.
- Persistent pain and fever despite otitis media treatment are critical symptoms.
- Intravenous antibiotics with myringotomy (with or without tubes) are effective initial management, comparable to mastoidectomy, unless complications are present.