Mastoiditis: Difference between revisions
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==Diagnosis== | ==Diagnosis== | ||
*Middle ear fluid cultures | *Middle ear fluid cultures | ||
*CT mastoid | *CT mastoid with IV contrast | ||
**Delineates extent of bony involvement | **Delineates extent of bony involvement | ||
**Helps to diagnosis abscess formation | |||
==Treatment== | ==Treatment== | ||
Revision as of 02:50, 5 June 2014
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 with IV contrast
- Delineates extent of bony involvement
- Helps to diagnosis abscess formation
Treatment
- IV Abx
- Vancomycin + (ceftazidime OR cefepime OR piperacillin-tazobactam)
Disposition
- Admit
See Also
Source
Tintinalli