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 Augmentin x 2wk after discharge

Disposition

• Admit

Source

Tintinalli