Summary
During recent years, a significantly increased incidence of acute mastoiditis was observed at the University Children's Hospital, Tübingen, Germany (1975–1979: 1.4 patients/year; 1987–1992: 4.2 patients/year; p<0.05). We therefore reviewed the records of all patients with acute mastoiditis (n=58) that had been treated at the Children's Hospital between 1975 and 1992 and at the Clinic of Otorhinolaryngology between 1978 and 1992. The male to female ratio was 1.8:1 and 60.4% of the patients were younger than 24 months. Retroauricular swelling was more often observed (n=49) than protrusion of the pinna (n=45) and retroauricular redness (n=38).Streptococcus pneumoniae was the most frequently isolated pathogen. Several factors predisposing for the development of acute mastoiditis were identified. These included withholding antimicrobials for treatment of the preceding episode of otitis media; use of suboptimal agents for therapy of otitis media (penicillin and, possibly, erythromycin ethylsuccinate); and insufficient duration of treatment.
Zusammenfassung
In den letzten Jahren wurde an der Univ.-Kinderklinik Tübingen eine signifikante Zunahme der Inzidenz der akuten Mastoiditis beobachtet (1975–1979: 1,4 Patienten/Jahr; 1987–1992: 4,2 Patienten/Jahr; p<0,05). Wir analysierten daher die Krankengeschichten aller Patienten mit akuter Mastoiditis (n=58), die zwischen 1975 und 1992 an der Universitäts-Kinderklinik und zwischen 1978 und 1992 an der Universitäts-Hals-Nasen-Ohrenklinik behandelt worden waren. Das Verhältnis von Jungen zu Mädchen betrug 1,8:1, und 60,4% der Patienten waren jünger als 24 Monate. Eine retroaurikuläre Schwellung wurde häufiger beobachtet (n=48) als ein abstehendes Ohr (n=45) und eine retroaurikuläre Rötung (n=38).Streptococcus pneumoniae war der häufigste Erreger. Mehrere für das Auftreten einer akuten Mastoiditis prädisponierende Faktoren wurden gefunden: die Nichtbehandlung der vorausgegangenen Otitis media mit Antibiotika, der Einsatz suboptimaler Antibiotika (Penicillin und möglicherweise Erythromycin-Ethylsuccinat) für die Otitis-Behandlung und eine ungenügende Therapiedauer.
Similar content being viewed by others
References
Ginsburg, C. M., Rudoy, R., Nelson, J. D. Acute mastoiditis in infants and children. Clin. Pediatr. 19 (1980) 549–553.
Palva, T., Virtanen, H., Mäkinen, J. Acute and latent mastoiditis in children. J. Laryngol. Otol. 99 (1985) 127–136.
Prellner, K., Rydell, R. Acute mastoiditis. Acta Otolaryngol. (Stockh.) 102 (1986) 52–56.
Nadal, D., Herrmann, P., Baumann, A., Fanconi, A. Acute mastoiditis: clinical, microbiological, and therapeutic aspects. Eur. J. Pediatr. 149 (1990) 560–564.
Ogle, J. W., Lauer, B. A. Acute mastoiditis. Am. J. Dis. Child. 140 (1986) 1178–1182.
Hawkins, D. B., Dru, D., House, J. W., Clark, R. W. Acute mastoiditis in children: a review of 54 cases. Laryngoscope 93 (1983) 568–572.
Faye-Lund, H. Acute und latent mastoiditis. J. Laryngol. Otol. 103 (1989) 1158–1160.
Paradise, J. L. Otitis media in infants and children. Pediatrics 65 (1980) 917–943.
Mathews, T. J., Oliver, S. P. Bacteriology of mastoiditis. J. Laryngol. Otol. 102 (1988) 397–398.
Rosen, A., Ophir, D., Marshak, G. Acute mastoiditis: a review of 69 cases. Ann. Otol. Rhinol. Laryngol. 95 (1986) 222–224.
Pfaltz, C. R., Griesemer, C. Complications of acute middle ear infections. Ann. Otol. Rhinol. Laryngol. 93 (Suppl. 112) (1984) 133–137.
Giebink, G. S., Canafax, D. M., Kempthorne, J. Antimicrobial treatment of acute otitis media. J. Pediatr. 119 (1991) 495–500.
Kamme, C., Lundgren, K., Runderantz, H. The concentration of penicillin V in serum and middle ear exudate in acute otitis media in children. Scand. J. Infect. Dis. 1 (1969) 77–83.
Ingvarsson, L., Kamme, C., Lundgren, K. Concentration of penicillin V in serum and middle ear exudate during treatment of acute otitis media. Ann. Otol. Rhinol. Laryngol. 89 (Suppl. 68) (1980) 275–277.
Kamme, C., Lundgren, K. Frequency of typable and non-typableHaemophilus influenzae strains in children with acute otitis media and results of penicillin V treatment. Scand. J. Infect. Dis. 3 (1971) 225–228.
Nilson, B. W., Poland, R. L., Thompson, R. S., Morehead, D., Baghdassarian, A., Carver, D. H. Acute otitis media: treatment results in relation to bacterial etiology. Pediatrics 43 (1969) 351–358.
Howie, V. M., Ploussard, J. H. The “in vivo sensitivity test” — bacteriology of middle ear exudate. Pediatrics 44 (1969) 940–944.
Howard, J. E., Nelson, J. D., Clahsen, J., Jackson, L. H. Otitis media of infancy and early childhood. Am. J. Dis. Child. 130 (1976) 965–970.
Bass, J. W., Steele, R. W., Wiebe, R. A., Dierdorff, E. P. Erythromycin concentrations in middle ear exudates. Pediatrics 48 (1971) 417–422.
Ginsburg, C. M., McCracken, G. H., Nelson, J. D. Pharmacology of oral antibiotics used for treatment of otitis media and tonsillopharyngitis in infants and children. Ann. Otol. Rhinol. Laryngol. 90 (1981) 37–43.
Kayser, F. H., Morenzoni, G., Santanam, P. The second European collaborative study on the frequency of antimicrobial resistance inHaemophilus influenzae. Eur. J. Clin. Microbiol. Infect. Dis. 9 (1990) 810–817.
McCracken, G. H. Selection of antimicrobial agents for treatment of acute otitis media with effusion. Pediatr. Infect. Dis. J. 6 (1987) 985–988.
Hendrickse, W. A., Kusmiesz, H., Shelton, S., Nelson, J. D. Five vs. ten days of therapy for acute otitis media. Pediatr. Infect. Dis. J. 7 (1988) 14–23.
Rubin, J. S., Wei, W. I. Acute mastoiditis: a review of 34 patients. Laryngoscope 95 (1985) 963–965.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Hoppe, J.E., Köster, S., Niethammer, D. et al. Acute mastoiditis — Relevant once again. Infection 22, 178–182 (1994). https://doi.org/10.1007/BF01716698
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF01716698