Mastoiditis

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ICD10 CODE: H70.0

Inflammation of the mastoid bone behind the ear

Cause

• Usually a complication of suppurative otitis media

Clinical features

• Severe pain felt over the mastoid bone
• Swelling in post auricular area (pinna is pushed down and forward)
• Current or history of pus discharge from the ear
• Fever
• Mental confusion is a grave sign of intracranial spread of infection (Refer to ENT surgeon immediately)

Differential diagnosis

• Inflamed lymph node behind ear

Investigations

• Diagnosis mainly by clinical features
• X-ray: Useful in chronic mastoiditis
• Blood: Full blood count, shows leucocytosis
• Examine ear with otoscope

Management

Treatment	LOC
Admit urgently; give emergency treatment Ceftriaxone 2-4 g by IV or deep IM once daily for 10-14 days Child: 50-80 mg/kg once daily Divide IM doses over 1 g between 2 sites Plus metronidazole 400 mg every 8 hours for 10-14 days Child: 7.5 mg/kg per dose Surgical drainage may be necessary to remove pus if an abscess has formed Refer urgently for specialist care	HC4