Clinical, laboratory, and microbiological differences between children with simple or complicated mastoiditis.
OBJECTIVE
To assess clinical, laboratory, and microbiological differences between children with simple and complicated mastoiditis.


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.


CONCLUSIONS
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.
Bilavsky
Efraim
E
Department of Pediatrics C, Schneider Children's Medical Center of Israel, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. yoji@netvision.net.il
Yarden-Bilavsky
Havatzelet
H
Samra
Zmira
Z
Amir
Jacob
J
Nussinovitch
Mosha
M
D002097:C-Reactive Protein / Q000378:metabolism; D002675:Child, Preschool; D015897:Comorbidity; D005260:Female; D005334:Fever / Q000453:epidemiology; D006784:Hospitals, Teaching / Q000706:statistics & numerical data; D006801:Humans; D007223:Infant; D007557:Israel / Q000453:epidemiology; D007958:Leukocyte Count; D008297:Male; D008417:Mastoiditis / Q000097:blood / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D009504:Neutrophils; D012189:Retrospective Studies; D012720:Severity of Illness Index
D002097:C-Reactive Protein