Complication of acute otitis media involving infection of the mastoid air cells

Aetiology

• Middle ear infections (otitis media) can spread to the mastoid air cells
• Most frequently bacterial - Strep. pneumoniae, H. influenzae

Pathophysiology

• The mastoid air cells are a suitable site for pathogenic replication due to their porous nature

Clinical features

• Pain, tenderness and swelling behind the ear

Investigations

• Imaging: CT, MRI

Management

• IV antibiotics and some cases may require surgical drainage

Complications

• The mastoid process itself can get infected, and this can spread to the middle cranial fossa, and into the brain, causing meningitis