Difference between revisions of "Mastoiditis"

(Clinical Features)
(Background)
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*Vast majority of acute mastoiditis occurs as a result of, or simultaneous with, acute otitis media
 
*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
 
**Mastoiditis is unlikely if middle ear examination is normal
 +
 +
===Etiology===
 +
*[[S. pneumo]] (22%)
 +
*[[S. pyogenes]] (16%)
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*[[S. aureus]] (7%)
 +
*[[H. flu]]
 +
*[[P. aeruginosa]]
  
 
==Clinical Features==
 
==Clinical Features==

Revision as of 17:42, 26 May 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

Etiology

Clinical Features

Mastoiditis with subperiostal abscess
  • 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

Diagnosis

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

Management

Antibiotics

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

Disposition

  • Admit

See Also

References