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Article: Mastoiditis Diagnosed by Clinical Symptoms and Imaging Studies in Children: Disease Spectrum and Evolving Diagnostic Challenges

TitleMastoiditis Diagnosed by Clinical Symptoms and Imaging Studies in Children: Disease Spectrum and Evolving Diagnostic Challenges
Authors
Issue Date2012
PublisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/722895/description#description
Citation
Journal of Microbiology, Immunology and Infection , 2012, v. 45 n. 5, p. 377-381 How to Cite?
AbstractBACKGROUND/PURPOSE: Acute mastoiditis has been increasingly reported. We reviewed our experience of mastoiditis in children in the era of expanding application of imaging tools and endless emerging antimicrobial resistance. METHODS: We reviewed all medical records of children (< 18 years of age) hospitalized with mastoiditis between January 2001and December 2010. Diagnosis of mastoiditis was based on clinical features and confirmed by imaging studies. Patients were classified as having acute or nonacute mastoiditis according to the duration of the disease. Acute mastoiditis was defined as illness of less than 3 weeks prior to hospitalization. Cases of longer than 3 weeks' duration were defined as nonacute mastoiditis. We compared the clinical, laboratory and microbiological features of acute and nonacute mastoiditis. RESULTS: A total of 104 children were enrolled in this study, comprising 56 acute cases and 48 nonacute cases. Fever and coryza were significantly more common in acute cases. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were both initially higher in acute mastoiditis. CRP, rather than ESR, declined faster in acute than in nonacute mastoiditis. Computerized tomography (CT) scans, but not plain films, were highly sensitive. Streptococcus pneumoniae and Haemophilus influenzae accounted for 52% of all isolates. Staphylococci, Pseudomonas spp. and polymicrobials were predominantly seen in non-acute mastoiditis. CONCLUSION: With the application of imaging studies, many cases of mastoiditis were identified. The classical postauricular signs were present in only 10% of patients. The presenting symptoms, inflammatory markers, pathogens, management and outcome were greatly influenced by the duration of the illness prior to admission.
Persistent Identifierhttp://hdl.handle.net/10722/199149
ISSN
2015 Impact Factor: 2.955
2015 SCImago Journal Rankings: 0.789
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChien, HJen_US
dc.contributor.authorChen, YSen_US
dc.contributor.authorHung, IFNen_US
dc.contributor.authorHsieh, KSen_US
dc.contributor.authorWu, KSen_US
dc.contributor.authorCheng, MFen_US
dc.date.accessioned2014-07-22T01:04:56Z-
dc.date.available2014-07-22T01:04:56Z-
dc.date.issued2012en_US
dc.identifier.citationJournal of Microbiology, Immunology and Infection , 2012, v. 45 n. 5, p. 377-381en_US
dc.identifier.issn1684-1182en_US
dc.identifier.urihttp://hdl.handle.net/10722/199149-
dc.description.abstractBACKGROUND/PURPOSE: Acute mastoiditis has been increasingly reported. We reviewed our experience of mastoiditis in children in the era of expanding application of imaging tools and endless emerging antimicrobial resistance. METHODS: We reviewed all medical records of children (< 18 years of age) hospitalized with mastoiditis between January 2001and December 2010. Diagnosis of mastoiditis was based on clinical features and confirmed by imaging studies. Patients were classified as having acute or nonacute mastoiditis according to the duration of the disease. Acute mastoiditis was defined as illness of less than 3 weeks prior to hospitalization. Cases of longer than 3 weeks' duration were defined as nonacute mastoiditis. We compared the clinical, laboratory and microbiological features of acute and nonacute mastoiditis. RESULTS: A total of 104 children were enrolled in this study, comprising 56 acute cases and 48 nonacute cases. Fever and coryza were significantly more common in acute cases. C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) were both initially higher in acute mastoiditis. CRP, rather than ESR, declined faster in acute than in nonacute mastoiditis. Computerized tomography (CT) scans, but not plain films, were highly sensitive. Streptococcus pneumoniae and Haemophilus influenzae accounted for 52% of all isolates. Staphylococci, Pseudomonas spp. and polymicrobials were predominantly seen in non-acute mastoiditis. CONCLUSION: With the application of imaging studies, many cases of mastoiditis were identified. The classical postauricular signs were present in only 10% of patients. The presenting symptoms, inflammatory markers, pathogens, management and outcome were greatly influenced by the duration of the illness prior to admission.en_US
dc.languageengen_US
dc.publisherElsevier Ltd. The Journal's web site is located at http://www.elsevier.com/wps/find/journaldescription.cws_home/722895/description#descriptionen_US
dc.relation.ispartofJournal of Microbiology, Immunology and Infectionen_US
dc.rightsNOTICE: this is the author’s version of a work that was accepted for publication in <Journal title>. Changes resulting from the publishing process, such as peer review, editing, corrections, structural formatting, and other quality control mechanisms may not be reflected in this document. Changes may have been made to this work since it was submitted for publication. A definitive version was subsequently published in PUBLICATION, [VOL#, ISSUE#, (DATE)] DOI#en_US
dc.subject.meshBacterial Infections - diagnosis - pathology - radiographyen_US
dc.subject.meshDiagnostic Tests, Routine - methodsen_US
dc.subject.meshHospitalizationen_US
dc.subject.meshMastoiditis - diagnosis - pathology - radiographyen_US
dc.subject.meshRadiology - methodsen_US
dc.titleMastoiditis Diagnosed by Clinical Symptoms and Imaging Studies in Children: Disease Spectrum and Evolving Diagnostic Challengesen_US
dc.typeArticleen_US
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_US
dc.identifier.authorityHung, IFN=rp00508en_US
dc.identifier.doi10.1016/j.jmii.2011.12.008en_US
dc.identifier.pmid22578647en_US
dc.identifier.hkuros230514en_US
dc.identifier.volume45en_US
dc.identifier.issue5en_US
dc.identifier.spage377en_US
dc.identifier.epage381en_US
dc.identifier.isiWOS:000310719000008-
dc.publisher.placeHong Kongen_US

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