Retrospective study of acute mastoiditis in children in Spain attended in a Pediatric Emergency department

Abstract

Objective

To analyze the cases of acute mastoiditis, characteristics, management and complications in children attended in the emergency department.

Methods

Retrospective study of acute mastoiditis in a Spanish tertiary hospital over a 6-year period (2018–2023).

Results

One hundred two episodes of acute mastoiditis were analyzed (54% males, median age 1.8 years). Microorganisms were isolated in one third of cases, mainly Streptococcus pyogenes (64% of ear secretion cultures). Complications occurred in 27.5%, primarily subperiosteal abscess. A younger age, absence of vaccination schedule, previous history of otitis, cochlear implant carriers or white blood cell counts and C-reactive protein levels were not associated with complications. Complicated cases had longer hospitalizations. Treatment included antibiotics, corticosteroids, and surgery in 50% of cases.

Conclusions

This study shows an increase of acute mastoiditis during 2023, with a relevant role of S. pyogenes. A younger age, absence of vaccination, personal history of otitis or cochlear implant, blood cell counts and C-reactive protein levels were not associated with complications.

Resumen

Objetivo

Analizar los casos de mastoiditis agudas, características, manejo y complicaciones en niños atendidos en urgencias.

Métodos

Estudio retrospectivo en un hospital terciario en España durante 6 años (2018-2023).

Resultados

Se analizaron 102 episodios de mastoiditis aguda (54% varones, mediana de edad de 1,8 años). Se aislaron microorganismos en un tercio, principalmente Streptococcus pyogenes (64% de cultivos óticos). Hubo complicaciones en el 27,5%, mayoritariamente abscesos subperiósticos. No observamos más complicaciones en niños <2 años, aquellos con calendario vacunal incorrecto, antecedentes de otitis, portadores de implante coclear o aquellos con alteraciones analíticas (leucocitosis, elevación de proteína C reactiva). Los casos complicados tuvieron hospitalizaciones más prolongadas. El tratamiento incluyó antibioterapia, corticoterapia y cirugía en el 50% de los casos.

Conclusiones

Comunicamos un aumento de casos de mastoiditis aguda en 2023, con relevancia de S. pyogenes. Factores como la edad, estado vacunal, antecedentes de otitis o implante coclear y parámetros sanguíneos no se relacionaron con complicaciones.