Mastoiditis history and symptoms: Difference between revisions

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{{Mastoiditis}}
{{Mastoiditis}}


{{CMG}}; {{AE}}
{{CMG}}; {{AE}}{{MJ}}


==Overview==
==Overview==
History and symptoms of mastoiditis ranges from not symptomatic disease to symptomatic and progressive mastoiditis with serious life-threatening complications.
History and [[symptoms]] of mastoiditis range from [[asymptomatic]] disease to [[symptomatic]] and progressive mastoiditis with serious life-threatening complications. History should be taken considering onset, duration, and progression of symptoms, [[allergies]], previous history of [[acute otitis media]], [[upper respiratory tract infection]], associated symptoms ([[otalgia]], [[fever]], [[confusion]]), [[medications]] including [[antibiotic]] usage in [[Acute otitis media|acute otitis media,]] [[snoring]], attendance to day care, history of [[trauma|trauma,]] co-morbid conditions like [[diabetes]], [[immunodeficiency]], and smoking. Common symptoms of mastoiditis are: [[ear pain]], [[fever]], feeling of "fullness" in the ear, recent episode of [[acute otitis media|acute otitis media,]] [[discharge]] from the affected ear, partial hearing loss, [[irritability]] (in infants), [[headache]], and [[lethargy]]/[[malaise|malaise.]] [[Neurological]] symptoms from chronic mastoiditis and [[otitis media]] with effusion include poor [[attention span]], delayed speech development, [[clumsiness]], and poor [[balance]]. Less common symptoms are gastrointestinal symptoms such as [[vomiting]] and [[diarrhea]], [[meningismus]], and [[torticollis]].


== History ==
== History ==
Obtaining the history is a very important aspect of making a diagnosis of mastoiditis. It provides insight into cause, precipitating factors and associated comorbid conditions.
Obtaining a detailed history is a very important aspect of diagnosis of mastoiditis. It provides insight into the causes, precipitating factors and associated comorbid conditions.
 
History should be taken considering the following:
* Onset, duration, and progression of symptoms


History taking should be considering below items:<ref name="pmid24466073">{{cite journal |vauthors=Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY |title=Risk factors for chronic and recurrent otitis media-a meta-analysis |journal=PLoS ONE |volume=9 |issue=1 |pages=e86397 |year=2014 |pmid=24466073 |pmc=3900534 |doi=10.1371/journal.pone.0086397 |url=}}</ref><ref name="pmid6877011">{{cite journal |vauthors=Holt GR, Gates GA |title=Masked mastoiditis |journal=Laryngoscope |volume=93 |issue=8 |pages=1034–7 |year=1983 |pmid=6877011 |doi= |url=}}</ref>
* Onset, duration and progression of symptoms
* [[Allergies]]
* [[Allergies]]
* Previous history of [[acute otitis media]]
* Previous history of [[acute otitis media]]
* [[Upper respiratory tract infection]]
* [[Upper respiratory tract infection]]
* Associated symptoms(otalgia, [[fever]], [[confusion]])
* Associated symptoms ([[otalgia]], [[fever]], [[confusion]])
* Medications
* [[Medications]], include [[antibiotic]] usage in [[acute otitis media]]
* [[Snoring]]
* [[Snoring]]
* Attendance to day care
* Attendance to day care
* History of [[Trauma]]
* History of [[trauma]]
* Co-morbid conditions like [[diabetes]], [[immunodeficiency]]
* Co-morbid conditions like [[diabetes]] or [[immunodeficiency]]
* [[Smoking]]: contributes to fluid buildup and blockage in the [[eustachian tube]]
* [[Smoking]], which contributes to fluid accumulation and blockage in the [[eustachian tube]]
* Mother [[smoking]] during pregnancy
* [[Smoking]] during pregnancy
* Occupations involving exposure to air pollution.
* Occupations involving exposure to [[air pollution]]
* Social status
* Social status<ref name="pmid24466073">{{cite journal |vauthors=Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY |title=Risk factors for chronic and recurrent otitis media-a meta-analysis |journal=PLoS ONE |volume=9 |issue=1 |pages=e86397 |year=2014 |pmid=24466073 |pmc=3900534 |doi=10.1371/journal.pone.0086397 |url=}}</ref><ref name="pmid6877011">{{cite journal |vauthors=Holt GR, Gates GA |title=Masked mastoiditis |journal=Laryngoscope |volume=93 |issue=8 |pages=1034–7 |year=1983 |pmid=6877011 |doi= |url=}}</ref><ref name="pmid18617870">{{cite journal |vauthors=van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG |title=A systematic review of diagnostic criteria for acute mastoiditis in children |journal=Otol. Neurotol. |volume=29 |issue=6 |pages=751–7 |year=2008 |pmid=18617870 |doi=10.1097/MAO.0b013e31817f736b |url=}}</ref>
 
mastoiditis — Characteristic features of acute coalescent mastoiditis include [1,38,39]:  ●Postauricular tenderness, erythema, swelling (with loss of the postauricular crease), fluctuance (or draining fistula), or mass (picture 1)  ●Protrusion of the auricle (picture 2)  ●Ear pain, which is a nonspecific finding and may manifest as irritability in young children  In a systematic review of the diagnostic criteria for acute mastoiditis (65 studies published between 1980 and 2007), the relative frequencies of clinical findings were as follows:  ●Lethargy/malaise (96 percent)  ●Abnormal tympanic membrane (82 percent)  ●Postauricular erythema, postauricular tenderness, and/or protrusion of the pinna (80 percent)  ●Fever (76 percent)  ●Narrowing of the external auditory canal (71 percent)  ●Ear pain (67 percent)  ●Otorrhea (50 percent)  Approximately 40 percent of children had a history of previous otitis media, and 50 percent had received antibiotics before admission.  Examination of the tympanic membrane usually reveals abnormal findings (eg, bulging, middle-ear effusion, perforation); however, often the tympanic membrane cannot be seen due to swelling of the external auditory canal. On average, 80 percent of children in the systematic review had acute otitis media (AOM) (picture 3) at the time of presentation [39]. However, the absence of AOM (current or recent) does not exclude a diagnosis of acute mastoiditis. Middle-ear effusion may be absent if there is obstruction of the aditus ad antrum with a patent eustachian tube (figure 1) [1]. (See 'Pathogenesis' above.)  Fever is a nonspecific symptom but is sensitive and may be predictive of complications or the need for surgical intervention [5,14,39,40]. High-spiking "picket-fence" fevers may be indicative of sigmoid sinus thrombophlebitis [41]. Other systemic symptoms and signs may include lethargy, malaise, irritability, poor feeding, or diarrhea [39].  Masked mastoiditis — Clinical features of masked (subacute) mastoiditis include fever, cough, ear pain, and tympanic membrane findings compatible with AOM (picture 3). Masked mastoiditis occasionally presents with an extracranial or intracranial complication without signs of AOM or mastoiditis [3].  Masked mastoiditis should be considered in children with AOM that is not responding to antibiotics and in children with signs of intracranial infection without another focus of infection. (See "Acute otitis media in children: Diagnosis", section on 'Otoscopy'.)
 
== Common Symptoms[edit | edit source] ==
* In this section you can list the common symptoms that the patient may experience.
* For an example of the common symptoms section within a history and symptoms section, click [[Pericarditis history and symptoms#Common Symptoms|here]].


== Less Common Symptoms[edit | edit source] ==
== Common Symptoms ==
* In this section you can list the less common symptoms that the patient may experience.
Common symptoms of mastoiditis are:
* For an example of the the less common symptoms section within a history and symptoms
* [[Ear pain]]
* [[Fever]]
* Feeling of "fullness" in the ear
* Recent episode of [[acute otitis media]]
* Fluid [[discharge]] in the ear
* Partial hearing loss
* [[Irritability]] (in infants)
* [[Headache]]
* [[Lethargy]]/[[malaise]]
* [[Neurological]] symptoms from chronic mastoiditis and [[otitis media]] with effusion:
** Poor [[attention span]]
** Delayed speech development
** [[Clumsiness]]
** Poor balance<ref name="pmid18617870">{{cite journal |vauthors=van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG |title=A systematic review of diagnostic criteria for acute mastoiditis in children |journal=Otol. Neurotol. |volume=29 |issue=6 |pages=751–7 |year=2008 |pmid=18617870 |doi=10.1097/MAO.0b013e31817f736b |url=}}</ref>


Some common [[symptoms]] and signs of mastoiditis include pain and tenderness in the mastoid region, as well as swelling. There may be ear pain ([[otalgia]]), and the ear or mastoid region may be red (erythematous). Fever or headaches may also be present. Infants usually show nonspecific symptoms, such as [[anorexia (symptom)|anorexia]], [[diarrhea]], or [[irritability]]. Drainage from the ear occurs in more serious cases.
== Less Common Symptoms ==
Less common mastoiditis symptoms are:
* [[Gastrointestinal]] symptoms such as [[vomiting]] and [[diarrhea]]  
* [[Meningismus]]
* [[Torticollis]]<ref name="pmid18617870">{{cite journal |vauthors=van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG |title=A systematic review of diagnostic criteria for acute mastoiditis in children |journal=Otol. Neurotol. |volume=29 |issue=6 |pages=751–7 |year=2008 |pmid=18617870 |doi=10.1097/MAO.0b013e31817f736b |url=}}</ref>


==References==
==References==
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{{WH}}
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[[Category:Emergency mdicine]]
[[Category:Disease]]
[[Category:Up-To-Date]]
[[Category:Infectious disease]]
[[Category:Otolaryngology]]
[[Category:Surgery]]

Latest revision as of 22:39, 29 July 2020

Mastoiditis Microchapters

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Overview

Historical Perspective

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Pathophysiology

Causes

Differentiating Mastoiditis from other Diseases

Epidemiology and Demographics

Risk Factors

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Natural History, Complications and Prognosis

Diagnosis

History and Symptoms

Physical Examination

Laboratory Findings

X Ray

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Future or Investigational Therapies

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]

Overview

History and symptoms of mastoiditis range from asymptomatic disease to symptomatic and progressive mastoiditis with serious life-threatening complications. History should be taken considering onset, duration, and progression of symptoms, allergies, previous history of acute otitis media, upper respiratory tract infection, associated symptoms (otalgia, fever, confusion), medications including antibiotic usage in acute otitis media, snoring, attendance to day care, history of trauma, co-morbid conditions like diabetes, immunodeficiency, and smoking. Common symptoms of mastoiditis are: ear pain, fever, feeling of "fullness" in the ear, recent episode of acute otitis media, discharge from the affected ear, partial hearing loss, irritability (in infants), headache, and lethargy/malaise. Neurological symptoms from chronic mastoiditis and otitis media with effusion include poor attention span, delayed speech development, clumsiness, and poor balance. Less common symptoms are gastrointestinal symptoms such as vomiting and diarrhea, meningismus, and torticollis.

History

Obtaining a detailed history is a very important aspect of diagnosis of mastoiditis. It provides insight into the causes, precipitating factors and associated comorbid conditions.

History should be taken considering the following:

  • Onset, duration, and progression of symptoms

Common Symptoms

Common symptoms of mastoiditis are:

Less Common Symptoms

Less common mastoiditis symptoms are:

References

  1. ↑ Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY (2014). "Risk factors for chronic and recurrent otitis media-a meta-analysis". PLoS ONE. 9 (1): e86397. doi:10.1371/journal.pone.0086397. PMC 3900534. PMID 24466073.
  2. ↑ Holt GR, Gates GA (1983). "Masked mastoiditis". Laryngoscope. 93 (8): 1034–7. PMID 6877011.
  3. ↑ 3.0 3.1 3.2 van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG (2008). "A systematic review of diagnostic criteria for acute mastoiditis in children". Otol. Neurotol. 29 (6): 751–7. doi:10.1097/MAO.0b013e31817f736b. PMID 18617870.

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