Difference between revisions of "Mastoiditis"

(Background)
(Treatment)
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==Treatment==
 
==Treatment==
 
*IV Abx
 
*IV Abx
**Vancomycin + (ceftazidime OR cefepime OR piperacillin-tazobactam)
+
**[[Vancomycin]] + (ceftazidime OR cefepime OR piperacillin-tazobactam)
  
 
==Disposition==
 
==Disposition==

Revision as of 05:06, 3 March 2014

Background

  • Inflammation of middle ear spreads into mastoid air cells via the "aditus ad antrum"
    • Can extend into cranial cavity and lead to brain abscess
  • Vast majority of acute mastoiditis occurs as a result of, or simultaneous with, acute otitis media
    • Mastoiditis is unlikely if middle ear examination is normal

Clinical Features

  • Abnormal TM findings
  • Abnormal mastoid findings
    • Erythema, edema tenderness
  • Abnormal pinna findings
    • Protrusion of auricle, obliteration of postauricular crease
  • Cranial nerve VI and VII palsies

Diagnosis

  • Middle ear fluid cultures
  • CT mastoid
    • Delineates extent of bony involvement

Treatment

  • IV Abx
    • Vancomycin + (ceftazidime OR cefepime OR piperacillin-tazobactam)

Disposition

  • Admit

See Also

Source

Tintinalli