Mastoiditis in the acute phase is infection of the mastoid air cells with purulent exudate. These air cells are contiguous with the middle ear, and infection occurs as a complication of otitis media.
4,800 (US); 288,000 (Global)
Estimated: days to weeks;
Symptoms of otitis media (otalgia, fever, decreased hearing) plus pain, swelling, and erythema of the mastoid process causing displacement of the pinna; [Harrisons, p. 251]
Acute mastoiditis is infection of the mastoid air cells with purulent exudate. These air cells are contiguous with the middle ear, and infection occurs as a complication of otitis media. [Harrisons, p. 251] Main causes in past were S. pneumoniae and H influenzae--pathogens may be changing due to increasing prevalence of vaccination. Main indications for antibiotics are pain, erythema, leukocytosis, and fever. [ABX Guide] Complications occur in about 18% of cases and include subperiosteal abscess (most common), meningitis, brain abscess, central venous sinus thrombosis, and osteomyelitis. [5MCC-2020] See "Otitis media.
Clinical; Rarely CT is needed; Send drainage for culture; Tympanocentesis may be indicated if no spontaneous drainage; [Merck Manual, p. 830]
SIGNS & SYMPTOMS
*brain abscess or lesion
Mastoidectomy if complicated case or antibiotics fail. [Harrisons, p. 251]
REFERENCES FOR CASES/YEAR
1. (US) 1.2-2.0 cases per 100,000 person-years in countries where antibiotics are readily available; [Harrison ID, p. 210] Calculate: 1.6/100,000 = 4800 cases/yr (US);
2. (Global) Assume 1/2 of global population has same rate as US and 1/2 has 5 X that rate; Then 10 x 4800 US cases/yr = 48,000 and 10 X 4800 X 5 = .240,000; 48,000 + 240,000 = 288,000;