Clinical Features of Acute Mastoiditis in Infants.

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The advent of broad spectrum antibiotics has allowed not only otologists, but also physicians and pediatricians easily to treat patients with acute infection of the middle ear cavity, and it has altered the clinical features and the course of acute mastoiditis. There are many fewer cases of acute mastoiditis with typical and classical signs and symptoms, such as ear pain, fever, aural discharge and postauricular abscess, and 'classical' mastoiditis has been largely replaced by a more chronic picture of 'latent' or 'masked' mastoiditis.We treated four infants with acute mastoiditis at the Medical College of Oita from 1981 to 1991. Two of them had typical signs and symptoms of classical mastoiditis secondary to acute otitis media. In the other two, the clinical features and course of acute mastoiditis were masked by the prior therapy with antibiotics. All four patients were successfully treated with simple mastoidectomy and postoperative antibiotic therapy. Etiological bacteria were cultured from two of the mastoids: Streptococcus pneumoniae and methicillin-(cephem)-resistant Staphylococcus aureus (MRSA).The clinical features of 'classical' and 'masked' mastoiditis in infants are compared and discussed.
耳鼻咽喉科臨床学会の論文