Article in Japanese

Clinical characteristics of mastoiditis in children

Kimihiro TANIGUCHI^1）, Kazuhiro UDA^2）, Hanako FUNAKOSHI^1）, Meiwa SHIBATA^1）, Keiko SONEDA^1）, Hiroshi HATAYA^3）, Yuho HORIKOSHI^1）

Mastoiditis is a rare complication of otitis media and may cause epidural abscess and meningitis. For mastoiditis treatment, broad-spectrum antibiotics, including Pseudomonas aeruginosa and methicillin-resistant Staphylococcus aureus (MRSA), are recommended in textbooks; however, in Japan, few studies about pediatric mastoiditis have been conducted. This study retrospectively reviewed cases of mastoiditis between March 2010 and December 2018 in the Tokyo Metropolitan Children’s Medical Center and recorded the characteristics, symptoms, and treatment of the patients. A total of 13 patients were identified. The median age was 1 year, and the percentage of male patients was 69％. Seven patients (54％) had acute otitis media, 11 patients (85％) had postauricular inflammatory findings, and 10 patients (77％) had protruding auricle upon diagnosis. All patients underwent computed tomography scan. Seven patients (54％) had osseous erosion and two patients had both epidural abscess and sigmoid sinus thrombosis. Nine patients (69％) had myringotomy and four patients (31％) had mastoidectomy. Streptococcus pneumoniae was isolated in five patients, followed by Streptococcus pyogenes in one patient. The remaining causative bacteria was unknown. Twelve patients were successfully treated with empirical antibiotic therapy without covering P. aeruginosa and appropriate drainage. The study suggests that antipseudomonal antibiotics may not always necessary for mastoiditis treatment.

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1）Division of Infectious Diseases, Department of Pediatrics, Tokyo Metropolitan Children’s Medical Center
2）Department of Pediatrics, Okayama University Hospital
3）Department of General Pediatrics, Tokyo Metropolitan Children’s Medical Center

Key words	mastoiditis, acute otitis media, children, antibiotics
Received	October 3, 2022
Accepted	May 3, 2023

35 (3)：227─234,2023