Early diagnosis can save children’s ears

A potentially serious ear infection can be managed better and severe complications avoided if physicians manage to diagnose it early enough and treat it properly, according to a new study by researchers in Qatar¹.  

Acute mastoiditis is a bacterial infection of the mastoid bones in the ear, which causes painful swelling and redness accompanied by fever, headaches and nausea. In severe cases, the infection spreads beyond the mastoid bones, leading to deafness, facial nerve paralysis, meningitis and intracranial and extracranial abscesses. 

The condition is relatively common in young children, but proper treatment leads to a full recovery in most cases.  

Shihab Mohammed Albaraznji of the Hamad Medical Corporation and his colleagues performed a retrospective study of 27 children aged 14 and under, all of whom had been admitted to paediatric emergency centres in Qatar between January 2005 and December 2008 and diagnosed with acute mastoiditis.  

More than three quarters of these patients presented with fever, and half of them reported ear pain. One developed an intracranial abscess that had to be surgically drained, but most of them began to improve within 2–3 days from the start of an intravenous antibiotic drip, and recovered fully after hospital stays averaging 8.5 days in length.  

“A lot of physicians are aware of acute mastoiditis, especially paediatricians and ear, nose and throat doctors,” says Albaraznji, “but we still need to make others aware of how serious this disease can be if it isn’t diagnosed and treated properly.” 

Acute mastoiditis is associated with a number of different bacteria, but this study identified Pseudomonas aeruginosa as the most common one present in the patient sample. It also revealed that the incidence of acute mastoiditis is slightly higher in Qatar compared to several European countries.  

The findings highlight the need for early diagnosis and proper treatment in which the causative infectious agent is identified and the right antibiotic used to fight it. Such treatment can bring the infection under control before it spreads and causes more severe complications.  

“Awareness of the disease is the best thing for early diagnosis, in addition to proper treatment of acute otitis media with the correct antibiotics. At the same time we need to avoid overuse of antibiotics to avoid resistance,” says Albaraznji.

1. Albaraznji, S. M., Al Ansari, K., Radi, M. M. Acute mastoiditis in children in the State of Qatar. J. Emerg. Med. Trauma Acute Care 2014, 6 (2014). | article