Acute mastoiditis in children

Design. - To determine the impact of the emergence of penicillin-resistant strains of pneumococci on the frequency of acute mastoiditis in children, a nd to assess the importance of laboratory and imaging studies in the treatm ent of acute mastoiditis. Method. - Retrospective review of the medical records of children with post auricular swelling and otoscopic signs of acute otitis media from January 1 993 through December 2000. Results. - Forty-eight children aged three months to 14 years (median 17 mo nths) were identified. The number of cases was almost the same from one yea r to another. All children had bacteriological examinations. The mastoid pu s and the otorrhea was sterile in 22 cases. The most frequent pathogen was Streptococcus pneumoniae (17 cases), which was resistant to penicillin in 7 1 % of cases. The initial body temperature, the number of polymorphonuclear s and the CRP were not different between the group of 18 children with peri ostitis, which required medical treatment alone, and the group of 30 childr en who had a mastoid abscess which required surgery. The difference between periostitis and mastoid abscess was seen on clinical examination and CTsca n. (C) 2001 Editions scientifiques et medicales Elsevier SAS.