Mastoiditis is an infection that affects the mastoid bone, located behind the ear.
It develops as a complication of acute suppurative otitis media, mostly in children.
This follows acute otitis media (untreated or inadequately treated), or due to particularly virulent organisms.
Infection spreads from the tympanum
posteriorly into the mastoid antrum and
Colliquative necrosis of the air cells and
suppuration in the mastoid bone follows.
A subperiosteal abscess forms behind the ear in a child with a discharging ear.
Symptoms and clinical features of Mastoiditis
- Pain behind the ear
- Mucopurulent ear discharge
- Progressive inflammatory swelling over the mastoid region
- Swelling is tender and fluctuant
- Suppurating post-aural lymphadenitis from otitis externa
Complications of Mastoiditis
Spread of infection into cranial cavity with:
- Extradural abscess
- Brain abscess
- Lateral sinus thrombophlebitis
- Ear swab for microscopy, culture, culture and sensitivity
- Radiographs of the mastoid
- Control and eradicate infection
- Prevent more serious complications
- Cortical mastoidectomy to open the mastoid
- Exenterate the infected air cells and drain the mastoid
A. Large doses of parenteral antibiotics
- Adult: 500 mg -1 g intravenously every 6-8 hours for 7 days
- Child: 50-100 mg/kg intravenously every 6-8 hours in divided doses daily for 7 days
- Adult: 1 g every 12 hours intravenously for 7 days
- by intravenous infusion over 60 minutes
- Neonates: 20-50 mg/kg once daily, by deep intramuscular injection, intravenous
injection over 2-4 minutes, or by intravenous
- 1 month – 12 years (body weight under 50 kg) 50 mg/kg once daily, up to 80 mg/kg in severe infections
- Adult: 500 mg-1 g orally every 4-6 hours (to a maximum of 4 g) for 5-7 days
- over 50 kg: same as adult dosing
- 6 – 12years: 250 – 500 mg;
- 3months – 5years: 125 – 250
mg taken orally every 4-6 hours for 5-7 days
- Bed rest: in-patient care
- Intravenous infusion as appropriate
- Adequate and timely treatment of acute otitis media