Acute mastoiditis: 20 years of experience with a uniform management protocol

International Journal of Pediatric Otorhinolaryngology
Tamer MansourMichal Luntz

Abstract

To characterize the clinical presentation of pediatric patients who, upon AM diagnosis, also had imaging-diagnosed ICCs (ID-ICCs); to define the group of AM patients at risk of developing ID-ICCs; and to update knowledge about organisms causing AM. Analysis of all AM patients admitted between 1997 and 2018 and treated according to an obligatory protocol including both brain imaging and sampling for bacterial culture upon clinical diagnosis of AM. Of 166 admitted patients (0.5-19 years old) 22 (13%) already had ID-ICCs. In patients who, on admission, had already received antibiotics for acute otitis media (AOM) and also had CRP (C-reactive protein) levels above 93.5 mg/L, the risk of ID-CC was increased by 22.5-fold (P < 0.0001). Bacterial culture results were available for all patients and were positive in 115 (69%). Organisms most commonly found in patients without prior antibiotic treatment were group A Streptococcus pyogenes (53%), Streptococcus pneumoniae (23%), and Haemophylus influenzae (11%), while with prior antibiotic treatment they were Fusobacterium necrophorum (21%), Streptococcus pyogenes (18%) and Pseudomonas aeruginosa (18%). Since the risk of ID-ICC in patients with the abovementioned CRP and prior antibiotic tr...Continue Reading

Citations

Sep 15, 2020·International Journal of Pediatric Otorhinolaryngology·Erdem Duygu, Sultan Şevik Eliçora
Aug 25, 2020·World Journal of Otorhinolaryngology - Head and Neck Surgery·Elise E ZhaoTed A Meyer
Oct 30, 2021·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Oren ZivSabri El-Saied
Oct 5, 2021·Clinical Otolaryngology : Official Journal of ENT-UK ; Official Journal of Netherlands Society for Oto-Rhino-Laryngology & Cervico-Facial Surgery·Matthew E SmithPeter Rea

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