Mastoiditis
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 PO abx x 2wk after discharge
- Ampicillin/sulbactam 100mg/kg IV q6hr until physical signs have diminished
Disposition
Admit
Source
Tintinalli