Mastoiditis – What are the signs and symptoms, relevant dDx., sequelae, work up, and treatment options?

January 5, 2021 5:28 am Published by

Mastoiditis is an infection of the mastoid, usually following acute otitis media, commonly caused by Streptococcus or Pneumococcus.

Sn. & Sx.:

  • Triad: otorrhea, tenderness over the mastoid, retroauricular swelling with protruding ear
  • Fever
  • Hearing loss
  • Tympanic membrane perforation (late)

dDx.:

  • Otitis media
  • Cellulitis
  • Parotitis
  • Neoplasm
  • Basilar skull fracture

Sequelae:

  • Hearing loss
  • Facial nerve palsy
  • Osteomyelitis
  • Labyrinthitis
  • CNS infection

Work up:

  • Culture discharge
  • Imaging (CT scan showing opacification of mastoid air cells)

Tx.:

  • Emergency referral 
  • IV antibiotics

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This post was written by Omar Rifai