Mastoiditis pathophysiology
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Mastoiditis Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Acute mastoiditis infection of the temporal bone mostly after otitis media of less than one month. In a setting of acute otitis media The mechanism of spread to mastoid air cells is by direct erosion of bone or through the mastoid emissary veins. Impaired air cell drainage in this context causes mastoiditis.[1][2]
During an episode of AOM, the mucosa lining the middle ear, and often that lining the mastoid, becomes inflamed [1]. In almost all cases, the inflammation resolves as the AOM improves. When inflammation persists, purulent material accumulates within the mastoid cavities (acute mastoiditis with periosteitis) [1,5,6]. As the pressure increases, the thin bony septae between air cells may be destroyed (coalescent mastoiditis)
Pathogenesis
- Most common bacteria causing acute Mastoiditis Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus
- The number of pneumococcal isolates and the percentage of isolates with high-level penicillin resistance from cultures taken from children with OM or mastoiditis for clinical indications have decreased following PCV13 use, largely due to decreases in serotype 19A isolates. [3]
- Staphylococci, Pseudomonas spp. and polymicrobials present predominantly seen in non-acute Mastoiditis.[4]
- Pseudomonas aeruginosa may be find in children with acute mastoiditis as a consequence of recurrent acute otitis media and antibiotic use[4]
References
- ↑ Lin HW, Shargorodsky J, Gopen Q (2010). "Clinical strategies for the management of acute mastoiditis in the pediatric population". Clin Pediatr (Phila). 49 (2): 110–5. doi:10.1177/0009922809344349. PMID 19734439.
- ↑ Pang LH, Barakate MS, Havas TE (2009). "Mastoiditis in a paediatric population: a review of 11 years experience in management". Int. J. Pediatr. Otorhinolaryngol. 73 (11): 1520–4. doi:10.1016/j.ijporl.2009.07.003. PMID 19758711.
- ↑ Kaplan SL, Center KJ, Barson WJ, Ling-Lin P, Romero JR, Bradley JS, Tan TQ, Hoffman JA, Peters TR, Gurtman A, Scott DA, Trammel J, Gruber WC, Hulten KG, Mason EO (2015). "Multicenter surveillance of Streptococcus pneumoniae isolates from middle ear and mastoid cultures in the 13-valent pneumococcal conjugate vaccine era". Clin. Infect. Dis. 60 (9): 1339–45. doi:10.1093/cid/civ067. PMID 25648240.
- ↑ 4.0 4.1 Chien JH, Chen YS, Hung IF, Hsieh KS, Wu KS, Cheng MF (2012). "Mastoiditis diagnosed by clinical symptoms and imaging studies in children: disease spectrum and evolving diagnostic challenges". J Microbiol Immunol Infect. 45 (5): 377–81. doi:10.1016/j.jmii.2011.12.008. PMID 22578647.