| Description |
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The clinical picture and the persistence or progression of the symptoms of the preceding acute suppurative otitis media provide the most important clues for the diagnosis of acute mastoiditis.
In the early stages of AOM, it is not unusual for pain and tenderness to be present over the mastoid area, especially in the region overlying the mastoid antrum. However, as the infection subsides, this pain is one of the first symptoms to disappear.
An increase in this pain and tenderness over the mastoid in a patient with AOM who has not been treated with antibiotics, or the recurrence or persistence of the mastoid pain and tenderness in a case of AOM which has been treated with antibiotics, should be considered a strong indicator that acute mastoiditis is developing.
In children with acute otitis media, the persistence or recurrence of fever after antibiotic treatment also suggests the presence of an underlying acute mastoid infection.
In those patients with a perforation in the tympanic membrane, an increase in the amount and purulence of the discharge usually indicates that the infection has spread into the mastoid air cells. |
