Mastoiditis: Difference between revisions

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==Disposition==
==Disposition==
*Admit
*Admit
==See Also==
*[[Otitis Media]]


==Source==
==Source==

Revision as of 19:07, 6 March 2012

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
    • Delineates extent of bony involvement

Treatment

  • IV Abx
    • Vancomycin + (ceftazidime OR cefepime OR piperacillin-tazobactam)

Disposition

  • Admit

See Also

Source

Tintinalli