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1144 ACUTE MASTOIDITIS: DIAGNOSIS AND COMPLICATIONS

Abstract

30 patients with 31 episodes of acute mastoiditis (AM) were identified by discharge diagnosis and studied retrospectively. There were 17 females and 13 males. The age range was 3 months to 14 years, with 43% less than 24 months. All had abnormal tympanic membranes. 27/31 had swelling above or posterior to the ear which deviated the pinna. Findings on mastoid films were clouding-16, osteomyelitis-2, and normal-7. In 14 patients organisms were recovered from normally sterile sites. The most frequent were Pneumococcus-5, group A streptococcus-3, Haemophilus-2, and anaerobes-3. 15/30 patients did well without surgery. In 23/31 episodes the patients were afebrile and much improved within 24 hours of hospitalization. Of these 23 episodes, 8 were treated surgically and 15 medically. In 8 episodes fever lasted longer than 24 hours. In 3/8 an intracranial complication had occurred; in 2/8 fever responded to a change in antimicrobials. Complications which occurred in 11/30 patients were subperiosteal abscess-7, meningitis-4, osteomyelitis-2, facial nerve palsy-1, and subdural and brain abscess-1. Of 6 patients with neurological complications, 4 had no external sign of AM on physical exam. In the absence of a complication, most patients will respond to antimicrobials within 24 hours. The absence of mastoid swelling does not rule out AM.

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Ogle, J., Lauer, B. 1144 ACUTE MASTOIDITIS: DIAGNOSIS AND COMPLICATIONS. Pediatr Res 19, 301 (1985). https://doi.org/10.1203/00006450-198504000-01174

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