Acute Mastoiditis in Children

Anthonsen, Kristian; Høstmark, Karianne; Hansen, S.; Andreasen, Kristian; Juhlin, Jon; Homøe, Preben; Cayé‐Thomasen, Per

doi:10.1097/inf.0b013e31828abd13

Cited by 55 publications

(20 citation statements)

References 16 publications

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“…For resistant species, adequate antibiotic therapy typically involves amoxicillin-clavulanate, cefuroxime, or intramuscular ceftriaxone [13]. This is in contrast to a recent report from Denmark, where 214 children with acute mastoiditis were studied [14]. In this report, S. pneumoniae was also the most prevalent pathogen, however only 6% of bacteria showed antibiotic resistance.…”

Section: Discussionmentioning

confidence: 59%

“…Over half of the patients had been previously treated with antibiotics at the time of presentation. Therefore, worsening symptoms despite appropriate treatment or new onset of more specific signs such as post-auricular erythema and edema or neurological deficits should lead one to consider the diagnosis of an acute complication of AOM [13,14].…”

Section: Discussionmentioning

confidence: 98%

See 1 more Smart Citation

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Mattos

Colman

Casselbrant

et al. 2014

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionmentioning

confidence: 59%

Section: Discussionmentioning

confidence: 98%

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Mattos

Colman

Casselbrant

et al. 2014

International Journal of Pediatric Otorhinolaryngology

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“…Due to the short interval between the introductions of PCV7 and PCV13 in Israel (spaced only 14 months), we were not able to witness any AM time trends after PCV7 introduction, as reported elsewhere (5)(6)(7)(8)(9). While some studies reported decreased AM rates after the introduction of PCV7 (7,10), others found no change or even an increase (11).…”

mentioning

confidence: 59%

Acute Mastoiditis in the Pneumococcal Conjugate Vaccine Era

Tamir

Roth

Dalal

et al. 2014

Clin. Vaccine Immunol.

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bFollowing the introduction of the 7-and 13-valent pneumococcal conjugate vaccines, we observed an inverse relationship between the increasing rate of immunized children and the proportion of middle ear fluid cultures collected during acute mastoiditis episodes that tested positive for Streptococcus pneumoniae among a subset of children 0 to 6 years old who had initially presented with severe acute otitis media and had bacterial cultures collected during tympanocentesis or from spontaneous otorrhea.A cute mastoiditis (AM) is a suppurative complication of acute otitis media (AOM), which often requires hospitalization and intravenous antibiotics and sometimes requires surgery. The most common otopathogen in AM is Streptococcus pneumoniae (1). In an attempt to control the impact of pneumococcal diseases, pneumococcal conjugate vaccines (PCVs) were gradually implemented in many countries during the past decade. In Israel, PCV7 was formally introduced into the national immunization program in July 2009 and was replaced by PCV13 in November 2010 (2). Both vaccines were or are, respectively, given at 2, 4, and 12 months of age. This change in the vaccination regimen allowed us to study the dynamics of AM incidence and bacteriology in a subset of children with AOM throughout a short time frame, from the pre-PCV7 era to the post-PCV13 era.This study was approved by the Edith Wolfson Medical Center's ethics review board. We retrospectively identified children 0 to 6 years of age who presented to the pediatric emergency room from 1 January 2008 through 31 December 2013 with severe AOM, defined as an AOM episode which either required tympanocentesis, due to a lack of clinical improvement after Ն48 h of antibiotic therapy, or presented with spontaneous otorrhea. In these children, we identified AM episodes (International Classification of Diseases code 383.0X). The AM diagnosis was based on clinical findings (postauricular tenderness, erythema or swelling, protruding auricle, palpable/fluctuating mass) and systemic signs (fever, lethargy, irritability, poor feeding, diarrhea). Children with previous ear surgery, immune deficiencies, and congenital malformations of the ear, nasopharynx, or palate were excluded from the study. In all eligible children, middle ear fluid (MEF) cultures were collected either during tympanocentesis with the use of a sterile flocked swab or from spontaneous otorrhea, from which pus was collected by swabbing the external ear meatus. Samples were processed for conventional cultures at the Edith Wolfson Medical Center's microbiology laboratory. MEF cultures that tested positive for external ear canal saprophytes were excluded.The PCV status for each AM episode was obtained from records at the Mother and Child Health Clinics, where all childhood vaccines are given in Israel. Each child was categorized according to his or her vaccination status at his or her AM presentation as either "unimmunized" if no dose of PCV immunization had been given or "any PCV7/PCV13 immunized" if Ն1 dose of PCV7/ PCV13 had b...

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“…5)) [68]. Even in cases of serotympanum, antibiotic therapy is effective [3], [71]. The complication rate under conservative antibiotic therapy is low and stable with around 2%.…”

Section: Evidence-based Therapeutic Approachesmentioning

confidence: 99%

Evidence and evidence gaps in the treatment of Eustachian tube dysfunction and otitis media

Teschner

2016

GMS Current Topics in Otorhinolaryngology - Head and Neck Surgery; 15:Doc05

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Acute Mastoiditis in Children

Cited by 55 publications

References 16 publications

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Intratemporal and intracranial complications of acute otitis media in a pediatric population

Acute Mastoiditis in the Pneumococcal Conjugate Vaccine Era

Evidence and evidence gaps in the treatment of Eustachian tube dysfunction and otitis media

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