Clinical, laboratory, and microbiological differences between children with simple or complicated mastoiditis

被引:30
作者
Bilavsky, Efraim [1 ]
Yarden-Bilavsky, Havatzelet [2 ]
Samra, Zmira [3 ]
Amir, Jacob [1 ]
Nussinovitch, Mosha [1 ]
机构
[1] Tel Aviv Univ, Sackler Fac Med, Schneider Childrens Med Ctr Israel, Dept Pediat C, IL-49202 Petah Tiqwa, Israel
[2] Tel Aviv Univ, Sackler Fac Med, Schneider Childrens Med Ctr Israel, Dept Pediat A, IL-49202 Petah Tiqwa, Israel
[3] Tel Aviv Univ, Sackler Fac Med, Rabin Med Ctr, Dept Clin Microbiol, IL-49202 Petah Tiqwa, Israel
关键词
Acute mastoiditis; Complications; Children; INTRACRANIAL COMPLICATIONS; MANAGEMENT;
D O I
10.1016/j.ijporl.2009.05.019
中图分类号
R76 [耳鼻咽喉科学];
学科分类号
100213 ;
摘要
Objective: To assess clinical, laboratory, and microbiological differences between children with simple and complicated mastoiditis. Patients and methods: Data on all children who were hospitalized at a tertiary center for acute mastoiditis over a 5-year period were collected from the computerized files. Findings were compared between those with simple mastoiditis vs. cases with intra- or extra-cranial complications. Results: Of the 308 children with acute mastoiditis, 55 (17.9%) had complicated disease. This group was characterized by a significantly higher maximal fever at presentation and higher absolute neutrophil count and C-reactive protein level than the children with simple disease. There was no statistically significant between-group difference in age, history of otitis media, prior antibiotic treatment, days of illness before presentation, absolute leukocyte count, and platelet count. No difference was detected between the groups in the penicillin and ceftriaxone susceptibility of the Streptococcus pneumoniae isolates. Conclusion: High-grade fever, high absolute neutrophil count, and high C-reactive protein level may serve as clinical and laboratory markers of complicated mastoiditis. Children with these findings warrant close follow-up and perhaps, earlier surgical intervention. (c) 2009 Elsevier Ireland Ltd. All rights reserved.
引用
收藏
页码:1270 / 1273
页数:4
相关论文
共 15 条
[1]   Acute mastoiditis: Increase in the incidence and complications [J].
Bartolome Benito, M. ;
Perez Gorricho, B. .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2007, 71 (07) :1007-1011
[2]   Intratemporal and intracranial complications of acute suppurative otitis media in children: renewed interest [J].
Dhooge, IJM ;
Albers, FWJ ;
Van Cauwenberge, PB .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 1999, 49 :S109-S114
[3]   Conservative management of acute mastoiditis in children [J].
Geva, Adi ;
Oestreicher-Kedem, Yael ;
Fishman, Gadi ;
Landsberg, Roee ;
DeRowe, Ari .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2008, 72 (05) :629-634
[4]  
Gliklich RE, 1996, ARCH OTOLARYNGOL, V122, P135
[5]   Intracranial complications of acute mastoiditis [J].
Go, C ;
Bernstein, JM ;
de Jong, AL ;
Sulek, M ;
Friedman, EM .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2000, 52 (02) :143-148
[6]   Acute mastoiditis in Southern Israel: a twelve year retrospective study (1990 through 2001) [J].
Katz, A ;
Leibovitz, E ;
Greenberg, D ;
Raiz, S ;
Greenwald-Maimon, M ;
Leiberman, A ;
Dagan, R .
PEDIATRIC INFECTIOUS DISEASE JOURNAL, 2003, 22 (10) :878-882
[7]  
KLEIN JO, 2004, PRINCIPLES PRACTICES, P766
[8]   Acute mastoiditis:: predictors for surgery [J].
Kvestad, E ;
Kværner, KJ ;
Mair, IWS .
INTERNATIONAL JOURNAL OF PEDIATRIC OTORHINOLARYNGOLOGY, 2000, 52 (02) :149-155
[9]  
LEWIS K, 1998, PRINCIPLES PEDIAT IN, P212
[10]   Acute mastoiditis in children: Epidemiologic, clinical, microbiologic, and therapeutic aspects over past years [J].
Nussinovitch, M ;
Yoeli, R ;
Elishkevitz, K ;
Varsano, I .
CLINICAL PEDIATRICS, 2004, 43 (03) :261-267