Difference between revisions of "Mastoiditis"

(Diagnosis)
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==Treatment==
 
==Treatment==
*IV Abx
+
===[[Antibiotics]]===
**[[Vancomycin]] + (ceftazidime OR cefepime OR piperacillin-tazobactam)
+
{{Mastoiditis Antibiotics}}
 +
 
  
 
==Disposition==
 
==Disposition==

Revision as of 01:16, 7 April 2015

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 with IV contrast
    • Delineates extent of bony involvement
    • Helps to diagnosis abscess formation

Differential Diagnosis

Ear Diagnoses

External

Internal

Inner/vestibular

Treatment

Antibiotics

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


Disposition

  • Admit

See Also

Source

Tintinalli