title: Acute mastoiditis in children: a 10-year retrospective and validated multicenter study.
abstract: BACKGROUND
  Conservative treatment of acute otitis media may lead to more complications. This study evaluates changes in incidence, the clinical and microbiological findings, the complications and the outcome of acute mastoiditis in children in a country employing conservative guidelines in treating acute otitis media.
  
  
  METHODS
  All admitted children (0-15 years) diagnosed with acute mastoiditis during the period from 1998 to 2007 in eastern Denmark (population 2.2 million) were identified. Patient files were retrieved and reviewed; the data were entered into a database.
  
  
  RESULTS
  The average incidence of admitted children with acute mastoiditis was 4.8/100,000 children per year (95% CI were ± 0.03 -0.04), and there was no change in the incidence during the 10-year period. Of the 214 children included (mean age 2.1 years, range 0.3-13.1, median 1.3 years), 100% presented with protrusion of the pinna and 95% with retroauricular swelling and redness, whereas 32% had a retroauricular abscess. Mastoidectomy had been performed in children with a retroauricular abscess. Thirty-one percent had a ventilation tube inserted. The remaining group was treated with antibiotics and analgesics, and 86% also had a myringotomy performed. Streptococcus pneumoniae and group A streptococci were the bacteria most commonly cultured, 94% being susceptible to penicillin. The complication rate was low at 1.9%. All children included were initially admitted; no patients were outpatients.
  
  
  CONCLUSIONS
  The incidence of acute mastoiditis is stable in eastern Denmark where conservative management guidelines for treating acute otitis media are used. Bacterial resistance toward penicillin is low (6%), complications are rare and the treatment outcome is good. Furthermore, no severe complications after treatment were observed.
authors: Department of Otorhinolaryngology, Head & Neck Surgery and Audiology, Rigshospitalet, Copenhagen, Denmark. kanthonsen@gmail.com
authors: Kristian
authors: K
authors: Anthonsen
authors: Karianne
authors: K
authors: Høstmark
authors: Søren
authors: S
authors: Hansen
authors: Kristian
authors: K
authors: Andreasen
authors: Jon
authors: J
authors: Juhlin
authors: Preben
authors: P
authors: Homøe
authors: Per
authors: P
authors: Caye-Thomasen
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003718:Denmark / Q000453:epidemiology; D004424:Ear Canal / Q000382:microbiology; D004432:Ear, Middle / Q000382:microbiology; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D008297:Male; D008417:Mastoiditis / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D012189:Retrospective Studies
chemical_list: D000900:Anti-Bacterial Agents