Materiały źródłowe

• #1 Mastoiditis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK560877/

  Mastoiditis can occur at any age, the majority of patients are less than two years of age, with a median age of 12 months. In the pre-antibiotic era, 20% of cases of acute otitis media were complicated by acute mastoiditis and frequently associated with severe intracranial complications. […] With the advent of antibiotics, mastoidectomy, and PCV-7 by 2008, the incidence has fallen drastically. Specifically, before the antibiotic era, 5 to 10% of children with acute otitis media developed coalescent mastoiditis with a mortality rate of 2/100000 population. After antibiotics and pneumococcal vaccination (PCV-7), 0.002% of children with acute otitis media progress too acute coalescent mastoiditis with a mortality rate of less than 0.01 per 100000 population.

• #2 Mastoiditis | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/24772

  Although mastoiditis can occur at any age, the majority of patients are less than two years of age, with a median age of 12 months. In the pre-antibiotic era, 20% of cases of acute otitis media were complicated by acute mastoiditis and frequently associated with severe intracranial complications. […] With the advent of antibiotics, mastoidectomy, and PCV-7 by 2008, the incidence has fallen drastically. Specifically, before the antibiotic era, 5 to 10% of children with acute otitis media developed coalescent mastoiditis with a mortality rate of 2/100000 population. After antibiotics and pneumococcal vaccination (PCV-7), 0.002% of children with acute otitis media progress too acute coalescent mastoiditis with a mortality rate of less than 0.01 per 100000 population.

• #3 Mastoiditis: Symptoms, Causes, and Treatment

  https://patient.info/doctor/mastoiditis

  Mastoiditis in acute or chronic form is now quite rare. […] The incidence in developed countries is 1.2-6.1 per 100,000. […] There is a rising incidence, however, which is connected to restrained antibiotic therapy of AOM, inadequate dosing, choice of antibiotics and increasing resistance of bacteria.

• #4 Mastoiditis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mastoiditis_epidemiology_and_demographics

  Mastoiditis incidence is 1.26.1 per 100,000 inhabitants in developed countries. Serious progressions appear more frequently in young children. After using pneumococcal vaccination, the rate of acute otitis media and mastoiditis decreased dramatically. However, there is a concern about rising incidence, which is connected to inadequate antibiotic dosing in otitis media, choice of antibiotics, and increasing resistance of bacteria. Acute mastoiditis is most common among children under two years of age. […] Mastoiditis incidence is 1.26.1 per 100,000 inhabitants in developed countries. Rapid disease progression appears to be more frequent in young children. After using pneumococcal vaccination, the rate of acute otitis media and mastoiditis decreased dramatically. However, there is a concern about rising incidence, which is connected to inadequate antibiotic dosing in otitis media, choice of antibiotics, and increasing resistance of bacteria.

• #5 Mastoiditis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/966099-overview

  Incidence of surgical mastoiditis from acute otitis media is reported as 0.004% in the United States. […] Some fear that untreated otitis media increases the risk of acute mastoiditis and is the cause of higher incidences in developing countries and very young children. […] The Inuit population has a high predilection for middle-ear disease and, as a likely consequence, mastoiditis. […] Rates of antibiotic treatment for otitis in the Netherlands, Norway, and Denmark were 31%, 67%, and 76%, respectively. The incidence of mastoiditis was approximately 4 cases per 100,000 children per year over 5 years. […] Acute mastoiditis is a disease of the very young. Most patients present when younger than age 2 years, with a median age of 12 months. However, it can occur in persons of any age. […] A retrospective review of pediatric patients in Colorado found that despite an initial drop in the incidence of acute mastoiditis in children under age 2 years following the introduction of heptavalent pneumococcal conjugate vaccine (PCV7), the incidence rose again to pre-PCV7 levels within a few years.

• #6 National incidence of pediatric mastoiditis in the United States, 2000-2012: creating a baseline for public health surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6541217/

  Between 2000-2012, the national estimated incidence rate of pediatric mastoiditis, a rare but serious complication of acute otitis media (AOM), was highest in 2006 (2.7 per 100,000 population) and lowest in 2012 (1.8 per 100,000 population). […] Mastoiditis surveillance can be used as a public health metric to identify if increases in this rare complication coincide with decreases in rates of diagnosis and associated antibiotic treatment for AOM. […] The objective of this study is to establish regional and temporal trends in the incidence of pediatric mastoiditis in the United States in the PCV-era (2000-2012) as a baseline for public health surveillance of unintended consequences of reducing antibiotic use for AOM. […] Mastoiditis incidence rates in the United States increased from 2000 to 2006 and then decreased from 2006 to 2012.

• #7 National incidence of pediatric mastoiditis in the United States, 2000-2012: creating a baseline for public health surveillance

  https://stacks.cdc.gov/view/cdc/79067

  Between 2000 and 2012, the national estimated incidence rate of pediatric mastoiditis, a rare but serious complication of acute otitis media, was highest in 2006 (2.7/100,000 population) and lowest in 2012 (1.8/100,000 population). […] This measure provides a baseline for public health surveillance in the pneumococcal conjugate vaccine era as stewardship efforts target antibiotic use in acute otitis media.

• #8 Acute mastoiditis | Evidence-Based Medicine Guidelines

  https://evidence.unboundmedicine.com/evidence/view/EBMG/453121/all/_________Acute_mastoiditis______?q=Leucocytosis

  The incidence in children in the Western countries is 24 infections/100,000 person-years. […] Acute and chronic purulent otitis media predisposes to mastoiditis.

• #9 EM@3AM: Mastoiditis – emDocs

  https://www.emdocs.net/em3am-mastoiditis/

  Epidemiology: […] Incidence of 0.6-4.2/100,000 children per year. […] Most common complication of acute otitis media (AOM). […] Younger children are more prone to mastoiditis—pneumatization of mastoid begins at birth and concludes around age 18. […] 30% of pediatric patients with mastoiditis suffer from recurrent AOM. […] Causative bacteria: Upper respiratory flora both aerobic and anaerobic. […] With new pneumococcal vaccination, rates of admission for mastoiditis and intracranial complications have remained the same. […] […] […] The appropriate management for acute mastoiditis is with systemic antibiotics such as intravenous ceftriaxone and admission. […] Acute mastoiditis is a potential complication of otitis media, which should serve as a reminder to providers that otitis media is a not altogether a benign condition.

• #10

  https://link.springer.com/article/10.1007/s00405-024-08473-8

  To describe characteristics of pediatric patients with recurrent acute mastoiditis, and to identify risk factors for this condition. […] During the 11-year period, a total of 1115 cases of children hospitalized due to acute mastoiditis were identified with a weighted incidence rate of 7.8/100,000. […] The incidence proportion of recurrent acute mastoiditis was 5.1% (57/1115), male-to-female ratio was 27:30, 73.4% were younger than 24 months, the median period from the first episode was 3.4 months (IQR 2.0;10.0), and 82.5% of the patients (n=47) had a single recurrence, whereas 18.5% (n=10) had two recurrences or more. […] Mastoidectomy and swelling over the mastoid area during the first episode were identified as the main risk factors for recurrent mastoiditis HR=4.7 [(2.78.2), p0.001] and HR=2.55 [(1.44.8), p=0.003], respectively.

• #11 Mastoiditis: Practice Essentials, Etiology, Epidemiology

  https://emedicine.medscape.com/article/966099-overview

  The investigators found that the annual incidence of acute mastoiditis in children under age 2 years dropped from 11.0 per 100,000 population in 2001, a year after PCV7 was introduced, to 4.5 per 100,000 population in 2003. […] By 2008, however, the incidence had again risen, to 12.0 per 100,000 population. […] Another study, however, found that the introduction of pneumococcal conjugate vaccines may have led to a national reduction in pediatric mastoiditis rates. […] Noting a reduction in US hospitalization rates for acute mastoiditis in children aged 0-2 years between 2009 and 2012, a study by Tawfik et al suggested that use of the 13-valent pneumococcal vaccine (PCV13) may have had a protective benefit against mastoiditis for youngsters in this age group.

• #12 Mastoiditis – Clinical Features – Investigations – TeachMePaeds

  https://teachmepaediatrics.com/ent/ear/mastoiditis/

  Around 75% of cases of acute mastoiditis occur in children under the age of 2 with a peak incidence at age 6-13 months. Since the introduction of antibiotics, acute and chronic mastoiditis have become quite rare. The incidence in developed countries is 1.2-6.1 cases per 100,000. […] The prognosis for the majority of cases that are diagnosed early is excellent with a low likelihood of complications occurring.

• #13 What Is Acute Mastoiditis?

  https://www.icliniq.com/articles/ear-health/acute-mastoiditis

  Mastoiditis can occur at any age, but pediatric age is most prone to mastoiditis. Most of the patients affected by this are less than two years of age, with an average of 12 months. This occurs due to anatomical, immunological, and infectious conditions in the first years of life. Therefore younger patients have a more rapid evolution of acute mastoiditis at different ages and can have more serious symptoms than adults. […] According to various studies, around 20 percent of cases of acute otitis media get complicated by acute mastoiditis and can be associated with severe intracranial complications.

• #14 Mastoiditis – Wikipedia

  https://en.wikipedia.org/wiki/Mastoiditis

  In the United States and other developed countries, the incidence of mastoiditis is quite low, around 0.004%, although it is higher in developing countries. The condition most commonly affects children aged from two to thirteen months, when ear infections most commonly occur. Males and females are equally affected.

• #15 Mastoiditis overview – wikidoc

  https://www.wikidoc.org/index.php/Mastoiditis_overview

  Mastoiditis incidence is 1.26.1 per 100,000 inhabitants in developed countries. Serious progressions appear more frequently in young children. […] After using pneumococcal vaccination, the rate of acute otitis media and mastoiditis decreased dramatically. However, there is a concern about rising incidence, which is connected to inadequate antibiotic dosing in otitis media, choice of antibiotics, and increasing resistance of bacteria. Acute mastoiditis is most common among children under two years of age. […] Men and women are affected equally by mastoiditis. Otitis media and therefore mastoiditis are more prevalent in developing countries, specifically Sub-Saharan West Africa, Southeast Asia, and Oceania. Risk factors that may contribute to higher incidence in developing countries include exposure to HIV, malnutrition, a large proportion of children under 5 years in the population, and higher chance of water contamination.

• #16

  https://link.springer.com/article/10.1007/s00405-024-08473-8

  Mastoidectomy was the only independent significant risk factor for recurrence in a multivariate analysis. […] Mastoidectomy and swelling over the mastoid area during the first episode of acute mastoiditis were found strongly related independent risk factor for future recurrent episodes of acute mastoiditis. […] The aim of our study was to better outline and assess the epidemiological and clinical features of pediatric patients with recurrent AM and to identify risk factors in order to assist in preventing future recurrent episodes which hold possible complications. […] The incidence of recurrent AM was 5.1% (57/1115). […] Analysis for risk factors related to recurrent episodes of AM revealed that the most significant factor was undergoing mastoidectomy during the initial episode of AM.

• #17 Mastoiditis epidemiology and demographics – wikidoc

  https://www.wikidoc.org/index.php/Mastoiditis_epidemiology_and_demographics

  Otitis media and therefore mastoiditis is most prevalent in developing countries, specifically Sub-Saharan West Africa, Southeast Asia, and Oceania. The incidence of otitis media in the above countries is between two and eight times higher than the rest of the world. The following risk factors are more prevalent in developing countries, correlated to the increase in otitis media incidence: Exposure to HIV, Malnutrition, Large proportion of children under 5 years old in population, Higher chance of water contamination.

• #18

  https://link.springer.com/article/10.1007/s00405-024-08704-y

  Common respiratory infections were significantly reduced during the COVID-19 pandemic due to general protective and hygiene measures. […] The aim of this retrospective monocentric study was to evaluate the impact of NPI during the COVID-19 pandemic on the incidence and severity of acute mastoiditis (AM). […] The cessation of NPI caused a steep rise in AM cases in both age groups starting from December 2022. […] NPI during the COVID-19 pandemic reduced the incidence of AM. Their reversal led to a substantial increase in the incidence of AM during the post-pandemic period, which may be due to a general increase in viral respiratory infections and an insufficiently trained immune system. […] Following the lifting of NPI, the number of patients with respiratory diseases treated in emergency departments is noticeably rising again.

• #19

  https://link.springer.com/article/10.1007/s00405-024-08704-y

  Throughout the COVID-19 pandemic, the complication rate was comparatively high in 2020 and 2021. […] The average complication rates during the COVID-19 pandemic were high, with 50% in 2020 and 75% in 2021. […] The rapid increase in viral respiratory disorders after the reduction of major pandemic restrictions and the reduced peri-pandemic exposure of the immune system to infectious agents particularly in children appear to trigger invasive bacterial infections and explain the steep rise in AM since December 2022.

• #20 National incidence of pediatric mastoiditis in the United States, 2000-2012: creating a baseline for public health surveillance

  https://pmc.ncbi.nlm.nih.gov/articles/PMC6541217/

  This study of mastoiditis among U.S. children from 2000 to 2012 estimated incidence rates over time and across regions, sexes, and age groups in the PCV era. These estimates may serve as a baseline for public health surveillance of this rare complication and could be used to monitor for unintended consequences of reducing antibiotic use for AOM, potentially informing antibiotic stewardship efforts.

• #21

  https://link.springer.com/article/10.1007/s00405-024-08473-8

  Mastoidectomy during the initial episode and swelling over the mastoid area during the first presentation were identified as the most significant independent risk factors for recurrent AM [HR=4.7 (2.78.2), p0.001] and [HR=2.55, 95% CI (1.44.8), p=0.003], respectively. […] This study is the first yet to point out a statistically significant correlation between the surgical treatment modality for AMmastoidectomyduring the first episode of AM, and the occurrence of further episodes of ipsilateral mastoiditis. […] Our study outlines characteristics of pediatric patients with recurrent AM (age, gender, clinical, and lab initial presentation), and that they were/were not statistically different than pediatric patients with a single episode of AM. […] The results of this study indicate that mastoidectomy, though a well-accepted first-line treatment, is an independent risk factor for recurrence of acute mastoiditis.

• #22 Is mastoiditis being over-diagnosed on computed tomography imaging? —radiological versus clinical findings – Pastuszek – Australian Journal of Otolaryngology

  https://www.theajo.com/article/view/4325/html

  Mastoiditis determined on CT imaging has a poor correlation with the clinical diagnosis and is seen in many incidental patients or alternative pathologies. […] In total, formal ENT consultation was requested in 27 patients (51.9%). Five patients (9.6%) were admitted, including those diagnosed with AM. […] Overall, from the 1,946 CT scan reports and images reviewed, 52 scans (2.7%) had reported mastoiditis. Only 5.8% (3 of 52) ended up with a specialist diagnosis of AM. Therefore, 94.2% of CT reports with reported mastoiditis did not end up with a clinical diagnosis of AM. […] Radiological reporting of mastoiditis is not in keeping with the clinical entity of AM. Based on this study, mastoid effusion or radiological reports of mastoiditis in the asymptomatic patient without evidence of bony erosion on CT is unlikely to require treatment beyond conservative approach (oral antibiotics or watch and wait).

• #23 Nocardia Mastoiditis in an Immunocompromised Patient

  https://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-3-033.php?jid=jide

  Nocardia is a gram positive bacteria that traditionally causes opportunistic infections in the immunocompromised population. It can be found worldwide, with more than half of known nocardia species being implicated in human or animal disease. Recognized as one of the least frequently encountered clinically important species of nocardia, only 67 cases were reported from 2000-2012. […] Nocardia species are opportunistic infectious agents often found in the immunocompromised population that commonly cause chronic granulomatous suppurative infections. Due to their ubiquitous presence in the environment, isolation of this gram positive bacteria needs to correlate with clinical findings. […] Of the 67 cases of Nocardia farcinica infections reported from 2000-2012, almost 60% were found to affect the lungs. Up to half of pulmonary nocardiosis cases have involvement outside the lungs, and approximately 20% of patients present only with extrapulmonary disease.

• #24 Nocardia Mastoiditis in an Immunocompromised Patient

  https://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-3-033.php?jid=jide

  It has been reported that Nocardia asteroides can cause mastoiditis in an HIV-infected patient, however, reports of N. farcinica causing disease, in particular mastoiditis, remain rare. […] Nocardia species are known to have distinct drug susceptibility patterns. Most all species of nocardia are susceptible to TMP/SMX, and thus it has become the backbone of modern day, multi-drug treatment. Nocardia farcinica has a more unique drug susceptibility pattern owing to this species being more virulent, with a mortality rate of more than 30%. […] We report a rare case of Nocardia farcinica mastoiditis in a patient with multiple myeloma and recurrent otitis media. We hope increasing awareness of this organism as a resistant pathogen will expedite diagnosis and targeted treatment in future cases.

• #25 Nocardia Mastoiditis in an Immunocompromised Patient

  http://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-3-033.php?jid=jide

  Nocardia is a gram positive bacteria that traditionally causes opportunistic infections in the immunocompromised population. It can be found worldwide, with more than half of known nocardia species being implicated in human or animal disease. Recognized as one of the least frequently encountered clinically important species of nocardia, only 67 cases were reported from 2000-2012. […] Nocardia species are opportunistic infectious agents often found in the immunocompromised population that commonly cause chronic granulomatous suppurative infections. […] Diagnosis of this pathogen requires proof of the organism in tissue, cultures, or both. […] Of the 67 cases of Nocardia farcinica infections reported from 2000-2012, almost 60% were found to affect the lungs. […] It has been reported that Nocardia asteroides can cause mastoiditis in an HIV-infected patient, however, reports of N. farcinica causing disease, in particular mastoiditis, remain rare.

• #26 Nocardia Mastoiditis in an Immunocompromised Patient

  http://clinmedjournals.org/articles/jide/journal-of-infectious-diseases-and-epidemiology-jide-3-033.php?jid=jide

  Nocardia species are known to have distinct drug susceptibility patterns. Most all species of nocardia are susceptible to TMP/SMX, and thus it has become the backbone of modern day, multi-drug treatment. […] N. farcinica has a more unique drug susceptibility pattern owing to this species being more virulent, with a mortality rate of more than 30%. […] We report a rare case of Nocardia farcinica mastoiditis in a patient with multiple myeloma and recurrent otitis media. We hope increasing awareness of this organism as a resistant pathogen will expedite diagnosis and targeted treatment in future cases.

• #27 EM@3AM: Mastoiditis – emDocs

  https://www.emdocs.net/em3am-mastoiditis/

  Infection from the middle ear spreads contiguously to the mastoid air cells and results in blockage of the aditus ad antrum (a connecting passage in the temporal bone) and subsequent filling of the mastoid air cells with fluid and infectious debris. […] Streptococcus pneumoniae is the most common causative organism, with S. pyogenes and Pseudomonas aeruginosa causing a minority of cases. […] CT with contrast of the temporal bone confirms the clinical diagnosis. […] […] […] Between 5-29% of patients will have intracranial complication. […] Recent antibiotic use for AOM generates more aggressive mastoiditis. […] Patients who have received recent antibiotics with CRP>93.5 mg/L have a 22x increased risk of intracranial complications. […] Mastoiditis accounts for 14% of subdural empyema cases. […] […] […] Mastoiditis is primarily a clinical diagnosis. […] 3% of mastoiditis patients will have normal TM. […] 60% of myringotomy fluid cultures are negative. […] Antibiotics and ENT consultation are needed.

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