Mastoiditis notes PDF

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Summary

pathophysiology, signs and symptoms, risk factors, investigations and management...

Description

Mastoiditis -

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Pathophysiology Inflammation of mastoid process Can be acute, chronic or a complication of otitis media Occurs when infection extends from middle ear by otitis media to mastoid air cells which leads to inflammation of bony destruction

Signs/symptoms: Acute History of acute/recurrent episode of otitis media Intense otalgia and pain behind ear Fever and Patient is unwell Swelling, redness, tender mass behind ear External ear can protrude forwards Discharge and Eardrum can be perforated Children  irritable, crying and feeding problems Chronic Bouts of otalgia and pain Recurrent headaches and fevers Tympanic membrane can be normal/perforated

Investigations: -

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Examination o Tympanic membrane can be performated o Mastoid area inflamed or swollen o Assess neurological involvement o Do weber’s test and rinne’s test o Rinne’s test may be negative FBC  Leukocytosis ESR and CPR  elevated Blood cultures

Differential diagnosis -

Otitis media Otitis externa

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Meningitis Cellulitis Parotid swelling Pyrexia of unknown origin

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Risk Factors: Common in young children at around age 6 – 13 months Immunocompromised Children/adults with intellectual impairment or communication difficulties Pre existence of cholesteatoma is also a risk factor

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Management: Admit to hospital if suspecting mastoiditis Initial therapy o High dose broad spectrum IV antibiotics Oral antibiotics after IV antibiotics Paracetamol and ibuprofen given as anti pyretics Myringotomy and tympanostomy tube Mastoidectomy...