Difference between revisions of "Mastoiditis"

(Background)
(Evaluation)
Line 34: Line 34:
 
*Middle ear fluid cultures
 
*Middle ear fluid cultures
 
*CT mastoid with IV contrast
 
*CT mastoid with IV contrast
 +
** 90% sensitive
 
**Delineates extent of bony involvement
 
**Delineates extent of bony involvement
 
**Helps to diagnosis [[abscess]] formation
 
**Helps to diagnosis [[abscess]] formation

Revision as of 17:33, 20 June 2019

Background

Etiology

Mastoiditis with subperiostal abscess

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

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Evaluation

  • Middle ear fluid cultures
  • CT mastoid with IV contrast
    • 90% sensitive
    • Delineates extent of bony involvement
    • Helps to diagnosis abscess formation

Management

Coverage against S. pneumoniae, S. pyogenes, S. aureus, H. influenzae

Disposition

  • ENT consultation - cases refractory to parenteral antibiotics may require surgical irrigation and debridement with possible mastoidectomy.
  • Admit

See Also

References