Mastoiditis (Pediatrics - PEDS)

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Mastoiditis is an inflammation or infection of the mastoid bone, which is one of the bones of the skull behind the ear.

It results from an infection of the middle ear. 

The most common symptoms are pain, redness or swelling behind the ear, ear pain, displacement of the pinna forward due to inflammation of the mastoid bone, fever, irritability or nervousness, headache and deafness.

The diagnosis will be made thanks to the clinical history, physical examination (with an otoscope), the performance of imaging tests and the possibility of ear drainage cultures.

Treatment consists of early administration of antibiotics, although there are cases in which it may be difficult to treat, requiring prolonged antibiotic treatment and even surgery to properly drain the pus from the area.

Bibliographic references
  1. Garcia C, Salgueiro AB, Luís C, Correia P, Brito MJ. Acute mastoiditis in children: Middle ear cultures may help in reducing use of broad spectrum antibiotics. Int J Pediatr Otorhinolaryngol. 2017 Jan;92:32-37.
  2. Carmel E, Curotta JH, Cheng AT.Prognostic effect of pre- and post-admission antibiotic treatment in paediatric acute mastoiditis. Laryngol Otol. 2017 Jan;131(S1):S12-S17.
  3. Attlmayr B, Zaman S, Scott J, Derbyshire SG, Clarke RW, De S.Paediatric acute mastoiditis, then and now: is it more of a problem now?.J Laryngol Otol. 2015 Oct;129(10):955-9.
  4. Marom T, Roth Y, Boaz M, Shushan S, Oron Y, Goldfarb A, Dalal I, Ovnat Tamir S. Acute Mastoiditis in Children: Necessity and Timing of Imaging. Pediatr Infect Dis J. 2016 Jan;35(1):30-4.
  5. Laulajainen-Hongisto A, Aarnisalo AA, Jero J. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children. Curr Allergy Asthma Rep. 2016 Oct;16(10):72.
Author
Dr. Maria Trabazo
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Symptoms

    Back of the ear is red and swollen


    Pain when touching the area behind the ear


    Sensation of pressure inside the ear


    Fever / Feel very hot


    Inflammation moved ear down and outwards

Symptoms to watch out for

High fever (102.2 ºF or more)
Discharge of whitish fluid (pus)
Hearing loss

Self-care

Take over-the-counter pain relievers or anti-inflammatories.
Consult with your primary care physician regarding the prescription of antibiotics.