Difference between revisions of "Mastoiditis"

(Background)
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*[[H. flu]]
 
*[[H. flu]]
 
*[[P. aeruginosa]]
 
*[[P. aeruginosa]]
 +
 +
[[File:Mastoiditis1.jpg|thumb|Mastoiditis with subperiostal abscess]]
  
 
==Clinical Features==
 
==Clinical Features==
[[File:Mastoiditis1.jpg|thumb|Mastoiditis with subperiostal abscess]]
 
 
*Abnormal TM findings
 
*Abnormal TM findings
 
*Abnormal mastoid findings
 
*Abnormal mastoid findings
**Erythema, edema tenderness
+
**Erythema, edema, tenderness
 
*Abnormal pinna findings
 
*Abnormal pinna findings
 
**Protrusion of auricle, obliteration of postauricular crease
 
**Protrusion of auricle, obliteration of postauricular crease
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{{Ear DDX}}
 
{{Ear DDX}}
  
==Diagnosis==
+
==Diagnostic Evaluation==
 
*Middle ear fluid cultures
 
*Middle ear fluid cultures
 
*CT mastoid with IV contrast
 
*CT mastoid with IV contrast
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==Management==
 
==Management==
===[[Antibiotics]]===
 
 
{{Mastoiditis Antibiotics}}
 
{{Mastoiditis Antibiotics}}
  
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==References==
 
==References==
 +
<References/>
  
 
[[Category:ENT]]
 
[[Category:ENT]]
 
[[Category:ID]]
 
[[Category:ID]]

Revision as of 07:07, 7 September 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

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

Diagnostic Evaluation

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

Management

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

Disposition

  • Admit

See Also

References