Difference between revisions of "Mastoiditis"

(Treatment)
(Disposition)
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==Disposition==
 
==Disposition==
Admit
+
*Admit
 +
**Many ENT are comfortable w/ PO abx and d/c if pt is well-appearing
  
 
==Source==
 
==Source==

Revision as of 20:21, 20 July 2011

Background

  • Inflammation of middle ear spreads into mastoid air cells 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

Diagnosis

  • Abnormal TM findings
  • Erythema, tenderness, edema over mastoid
  • Cranial nerve VI and VII palsies

Work-Up

  • Blood/middle ear fluid cultures
  • CT mastoid

Treatment

  • Abx
    • Ampicillin/sulbactam 100mg/kg IV q6hr until physical signs have diminished
      • Follow by Augmentin x 2wk after discharge

Disposition

  • Admit
    • Many ENT are comfortable w/ PO abx and d/c if pt is well-appearing

Source

Tintinalli