| ID | 283 |
|---|---|
| Name | ACUTE MASTOIDITIS |
| Cause | Mastoiditis is most often caused by a middle ear infection (acute otitis media). The infection may spread from the ear to the mastoid bone. The bone has a honeycomb-like structure that fills with infected material and may break dow |
| Signs Symptoms | Drainage from the ear. Ear pain or discomfort. Fever, may be high or suddenly increase. Headache. Hearing loss. Redness of the ear or behind the ear. Swelling behind the ear, may cause ear to stick out or feel as if it is filled with fluid. |
| Diagnosis | With small magnifying lens called an otoscope to check for infection inside the ear. Refer to ENT specialist Diagnosis of mastoiditis is clinical. CT is usually done, especially if an intratemporal or intracranial complication is suspected, to confirm the diagnosis and show the extent of the infection. Any middle ear drainage is sent for culture and sensitivity |
| Investigations | Witg small magnifying lens called an otoscope to check for infection inside the ear. Refer to ENT specialist Diagnosis of mastoiditis is clinical. CT is usually done, especially if an intratemporal or intracranial complication is suspected, to confirm the diagnosis and show the extent of the infection. Any middle ear drainage is sent for culture and sensitivity |
| Management | Management: 1. In case where abscess has not been formed- Initial treatment consists of parenteral systemic antibiotic for 10 to 15 days. Then antibiotic may be continued orally for further 5 days. 2. In cases with subperiosteal abscess formation- cortical mastoid operation followed by broad spectrum antibiotic is applied. Conservative treatment to be given maximum for 48 hours. |
| Introduction | Acute mastoiditis results in a cellular mastoid bone by spread of infection from the middle ear causing coalescence of air cells. |
| History | |
| Etiology | See under Causes |
| Clinical Features | Clinical features: 1. It is common in children & usually follows an attack of acute suppurative otitis media & incomplete resolution. 2. The symptoms suddenly recur or become more severe. There is acute pain in the ear & post-auricular region. Aural discharge increase & temp, rises to 101-102°F. 3. Tenderness, oedema & abscess on the mastoid bone. Ear shows profuse discharge of pus. Sometimes pulsating discharge from tympanic membrane perforation. 4. X-ray of mastoid bone shows- haziness of the mastoid air cells & also coalescence. |
| Preventions | |
| Treatment | Postauricular swelling and erythema without subperiosteal abscess or mastoid osteitis can be treated more conservatively, using parenteral antibiotics, high-dose steroids, and tympanostomy tube insertion. Vancomycin and ceftriaxone are recommended until cultures become available. |
| Complications | Destruction of the mastoid bone. Dizziness or vertigo. Epidural abscess. Facial paralysis. Meningitis. Partial or complete hearing loss. Spread of infection to the brain or throughout the body. |
| Prognosis | cure rates for the disease were found to be 95.9%, 96.3%, and 89.1%, |
| Types | |
| Classification | |
| Observation | |
| Pathology |
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