Mastoiditis: Difference between revisions
Line 20: | Line 20: | ||
==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
- Ampicillin/sulbactam 100mg/kg IV q6hr until physical signs have diminished
Disposition
- Admit
- Many ENT are comfortable w/ PO abx and d/c if pt is well-appearing
Source
Tintinalli