Acute mastoiditis in children in the State of Qatar

Abstract

Background:Acute mastoiditis is a serious complication of otitis media. Its diagnosis and treatment carry a great importance due to its potentially serious consequences. This study was designed to evaluate recent clinical experiences with pediatric acute mastoiditis in the State of Qatar. Our objectives were to highlight the importance of this disease and its possible complications, which emphasize the necessity of early diagnosis and proper treatment. We also assessed the commonality of this condition compared to some other countries as well as explored their experience in this regard.Materials and Methods:This is a retrospective study of all children ≤ 14 years presenting to the pediatric emergency centers (PEC) in the State of Qatar between January 2005 and December 2008, with a clinical diagnosis of acute mastoiditis supported by CT scan findings.Results:Twenty-seven patients were diagnosed with acute mastoiditis during the study period, with a mean age of 5.4 years. Only four children were diagnosed with otitis media and started on antibiotics a few days prior to presentation. The following signs and symptoms recorded on presentation were: fever in 77%, ear pain in 51%, ear discharge in 40%, postauricular swelling in 100%. The most frequent pathogen cultured by ear swab wasPseudomonas aeruginosa(in six out of sixteen patients who presented with ear discharge). One patient needed surgical intervention for mastoid abscess. There were two recorded complications of mastoid abscess in one patient that needed drainage and facial palsy in three patients. No mortality was reported during the study period.Conclusions:Acute mastoiditis in children is not uncommon in the State of Qatar. Full recovery with conservative treatment is noticed in most cases.Pseudomonas aeruginosais a common pathogen which indicates the need for broader systemic coverage in early diagnosis. Moreover, in order to promote adequate management and prevent inherently severe complications, great care is required from clinicians to reach early diagnosis. Involvement of the otolaryngology physician from the beginning is very significant.