Mastoiditis

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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

Disposition

Admit

Source

Tintinalli

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