Acute Mastoiditis in Children: On the Rise Again?

Date of submission: 10-09-2017 | Date of acceptance: 19-07-2018 | Published: 29-01-2019

Abstract

Introduction: Acute mastoiditis is an otological disease that can lead to serious complications. Recent studies denote an increase in the incidence of mastoiditis. The aim of this study was to evaluate that disease frequency and characteristics in one secondary hospital in the past five years and to compare with previous years.

Methods: Retrospective study of children with acute mastoiditis admitted between 2011 and 2015.

Results: During this period, 105 acute cases of mastoiditis were diagnosed in 98 children (46 more than in the previous five years). The median age was 6 years, with male predominance (58%, n = 57). It was presented at least one otorhinolaryngological risk factor in 52% (n = 55) and 51% (n = 54) used a prior antibiotic. Otalgia (92%, n = 97) and inflammatory signs of the postauricular region (93%, n = 98) were the major clinical findings. Overall, 43% (n = 45) presented > 15 x 109 white blood cells/L and 35% (n = 37) C-reactive protein > 4 mg/ dL. Computed tomography and lumbar puncture were performed in those with no improvement (n = 31, 30% and n = 3, respectively). Complications occurred in 7% (n = 7), three extracranial and four intracranial, mostly in children below three years (p = 0.04). Headache was more frequent in the group with complications (p = 0.007). All of the patients were treated with intravenous antibiotics and 19% (n = 20) needed surgical intervention, in which 35% of those were urgent (n = 7). Relapse was observed in 10% (n = 10).

Discussion: Similar to some studies, we found an increase in the frequency of acute mastoiditis in the last five years. The rate of complications was also analogous to other studies.