ACUTE MASTOIDITIS IN CHILDREN – RISK FACTORS FOR COMPLICATIONS
Keywords:Acute mastoiditis, child, complications, AOM
Introduction: Acute mastoiditis is the most frequent complication of acute otitis media. Antimicrobial therapy and healthcare improvement have dramatically decreased its incidence, although in the last decade a resurgence of the disease has been noticed.
Objectives: To evaluate sociodemographic, clinical, laboratory and therapeutic features of acute mastoiditis and to identify risk factors for complications in the paediatric population at a level II hospital; development of a proposed guideline.
Materials and methods: Systematic review of patients’ charts admitted with the diagnosis of AM in the 2000 -2010 period.
Results: Sixty patients (55 children) were admitted, predominantly male (53,3%). More than 1/3 (36,7%) of cases occurred in 2000 and 2006. The median age was Þ ve years. Nineteen patients (31,7%) had a previous history of recurrent middle ear infections, and 25 (41,7%) had other ENT disorders. 48,3% had a recent diagnosis of acute otitis media, all submitted to antimicrobial therapy. The symptoms were fever (75%), otalgia (93,3%), local inß ammatory signs (100%) and otorrhea (36,7%). Middle ear effusion, gathered by swabs, was cultured in nine cases, with Pseudomonas aeruginosa isolated in one case. Complications were found in eight patients (13,3%). Younger age (less than two years old), male sex, prior antimicrobial therapy, absence of otalgia were more common in complicated cases (p ≤ 0,05). All patients were submitted to IV antibiotics: 53,3% with second/third generation cephalosporins, for an average of 13 days. Three patients required surgery.
Conclusion: Against some databases, there wasn’t an increased number of admissions for MA, over the years of the study. Age less than two years, male gender, previous antimicrobial therapy and absence of ear pain seem to be predictive factors for complications. The criterious use of antimicrobial therapy and myringotomy should be emphasized.
in a paediatric
population: a review of 11 years experience in management.
Int J of Pediatr Otorhinolaryngol 2009;73:1520 -4.
Spratley J, Silveira H, Alvarez I, Pais -Clemente M. Acute
mastoiditis in children: review of the current status. Int J of
Pediatr Otorhinolaryngol 2000;56:33 -40.
Santander BC, González AP, Santaella IO. Mastoiditis aguda:
experiencia en los últimos 10 años en hospital terciário del
sur de España. An Pediatr (Barc) 2010;72:257 -62.
Martins C, Lopes A, Marques E. Mastoidite aguda. Experiência
de 7 anos. Acta Pediatr Port 2008;39:8 -11.
Salgueiro AB, Brito MJ, L Catarina, Machado MC. Mastoidites
na idade pediátrica. Acta Pediatr Port 2007;38:257 -61.
Paramás AR, Losa MM, Pedro FG, Encinas A, Triguero MG.
Mastoiditis aguda infantil. Estudio retrospectivo y revisión de
la literatura. Acta Otorrinolaringol Esp 2006;57:165 -70.
Nussinovitch M, Yoeli R, Elishkevitz K, Varsano I. Acute
mastoiditis in children: epidemiologic, clinical, microbiologic,
and therapeutic aspects over past years. Clinical Pediatrics
Kvaerner KJ. Lessons learned: no increase despite clinical of
acute mastoiditis. Eur Arch Otorhinolaryngol 2009;266:653 -6.
Quesnel S, Nguyen M, Pierrot S, Contencin P, Manach Y, Couloigner.
Acute mastoiditis in children: a retrospective study of
patients. Int J Pediatr Otorhinolaryngol 2010;74:1388 -92.
Hermansson A, Stenfeldt K. Acute mastoiditisin Southern
Sweden: a study of occurrence and clinical couse of acute
mastoiditis before and after introduction of new treatment
recommendations for AOM. Eur Arch Otorhinolaryngol
Lin HW, Shargorodsky J, Gopen Q. Clinical Strategies for the
management of acute mastoiditis in the pediatric population.
Clinical Pediatrics 2010;49:110 -5.
Tamir S, Schwartz Y, Peleg U, Perez R, Sichel JY. Acute mastoiditis
in children: Is Computed Tomography always necessary?.
Ann of Otology, Rhinology &Laryngol 2009;118:565 -9.
Lemos L, Xavier B. Recomendações sobre a terapêutica inicial
da otite média aguda. Acta PediatrPort 2002;33:25 -6.
Kvestad E, Kvaerner EJ, Mair IW. Acute mastoiditis: Predictors
for surgery. Int J Pediatr Otorhinolaryngol 2000;52:149 -55.
Heslop A, Ovesen T. Severe acute middle ear infections:
microbiology and treatment. Inter J Pediatrotorhinolaryngol
;70:1811 -6. Epub 2006 Aug 14.
Taylor MF, Berkowitz RG. Indications for mastoidectomy
in acute masto
How to Cite
Copyright and access
This journal offers immediate free access to its content, following the principle that providing free scientific knowledge to the public provides greater global democratization of knowledge.
The works are licensed under a Creative Commons Attribution Non-commercial 4.0 International license.
Nascer e Crescer – Birth and Growth Medical Journal do not charge any submission or processing fee to the articles submitted.