Mastoiditis physical examination
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Mastoiditis Microchapters |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mehrian Jafarizade, M.D [2]
Overview
Acute mastoiditis patients are usually ill-appearing and usually present with low-grade fever. Patients with complicated mastoiditis may appear severly ill. Mastoiditis physical examination findings include posterior auricular signs such as postauricular swelling, erythema, tenderness, protrusion of pinna, and sagging external ear canal. Otoscopic examination findings include erythema, bulging, cloudy appearance, and immobility of the tympanic membrane.
Physical Examination
Patients with mastoiditis may present with some or all of the following signs:[1][2][3][4][5]
Appearance of the Patient
Patients with mastoiditis usually appear ill and have marked inflammation and edema of the periauricular area.
Vital Signs
Patients with mastoiditis may have the following vital signs, which are suggestive of infection:
Skin
Patients with mastoiditis may present with the following skin findings:
HEENT
Patients with mastoiditis may have the following HEENT findings on physical examination:
Head
Patients with mastoiditis may present with the following signs:
- Evidence of recent eye trauma
- Evidence of recent insect bites
Ear
Patients with mastoiditis may present with the following signs:
- Otorrhea
- Postauricular swelling
- Postauricular erythema
- Postauricular tenderness
- Protrusion of pinna
- Sagging external ear canal
- Blurred tympanic membrane
Mastoiditis patients may present with signs that are suggestive of inner or middle ear infection:
- Erythema, edema, and discharge present on otoscopy
- Hearing loss
- Children may show signs of "tugging" on the affected ear
Throat/Oral
Patients with mastoiditis may present with signs which are suggestive of oral, pharyngeal, or upper respiratory tract infections:
Neck
Patients with mastoiditis may present with tender cervical lymph nodes, which are suggestive of regional infection.
References
- ↑ Zhang Y, Xu M, Zhang J, Zeng L, Wang Y, Zheng QY (2014). "Risk factors for chronic and recurrent otitis media-a meta-analysis". PLoS ONE. 9 (1): e86397. doi:10.1371/journal.pone.0086397. PMC 3900534. PMID 24466073.
- ↑ Holt GR, Gates GA (1983). "Masked mastoiditis". Laryngoscope. 93 (8): 1034–7. PMID 6877011.
- ↑ van den Aardweg MT, Rovers MM, de Ru JA, Albers FW, Schilder AG (2008). "A systematic review of diagnostic criteria for acute mastoiditis in children". Otol. Neurotol. 29 (6): 751–7. doi:10.1097/MAO.0b013e31817f736b. PMID 18617870.
- ↑ Lin HW, Shargorodsky J, Gopen Q (2010). "Clinical strategies for the management of acute mastoiditis in the pediatric population". Clin Pediatr (Phila). 49 (2): 110–5. doi:10.1177/0009922809344349. PMID 19734439.
- ↑ Pang LH, Barakate MS, Havas TE (2009). "Mastoiditis in a paediatric population: a review of 11 years experience in management". Int. J. Pediatr. Otorhinolaryngol. 73 (11): 1520–4. doi:10.1016/j.ijporl.2009.07.003. PMID 19758711.