Mastoiditis in Children

Mastoiditis is an infection that affects the bony area of the skull, behind the ears (mastoid process and mastoid cavity).

This condition may need to be treated in a hospital if it is severe. Many cases can be treated by giving your child antibiotic medicine at home.

What are the causes?

This condition is caused by bacteria. It may develop after your child has a middle ear infection.

What increases the risk?

The following factors make your child more likely to develop mastoiditis:

• Being a young child. It is most common in children younger than 2 years of age.
• Having multiple ear infections, with fluid constantly draining from the ear.
• Having a weak disease-fighting system (immune system).

What are the signs or symptoms?

Symptoms of this condition may include:

• Pain, redness, and swelling behind the ear. The ear itself may also turn red and swell.
• The ear lobe may be pushed out, causing a narrowing of the ear canal.
• Fever.
• Fluid draining from the ear.
• Headache.
• Hearing problems, such as muffled hearing.
• Dizziness.
• Nausea.

How is this diagnosed?

This condition may be diagnosed based on:

• Your child’s symptoms, physical exam, and medical history.
• A blood test.
• Testing a sample of fluid that drains from the ear (culture).
• Imaging tests, such as an X-ray, CT scan, or MRI.

How is this treated?

Treatment depends on how serious the infection is. Severe cases may require treatment in the hospital. Treatment may include:

• Antibiotic medicine. This may be given by mouth or through an IV inserted into one of your child’s veins.
• A procedure to relieve pressure in the middle ear (myringotomy).
• A procedure to remove infected tissue from the mastoid process (mastoidectomy).

Follow these instructions at home:

• Give your child antibiotic medicine as told by his or her health care provider. Your child should not stop taking the antibiotic even if he or she starts to feel better.
• Give your child over-the-counter and prescription medicines only as told by your child’s health care provider.
• Do not give your child aspirin, because of the association with Reye syndrome.
• Keep all follow-up visits as told by your child’s health care provider. This is important.

Contact a health care provider if your child has:

• A fever.
• A headache.
• New pain in the ear or face.
• Hearing loss or trouble hearing.
• Nausea.
• Vomiting.
• A rash.
• Diarrhea.

Get help right away if your child:

• Has a severe headache.
• Has severe pain in the ear or face.
• Has sudden hearing loss.
• Vomits repeatedly.
• Develops weakness or drooping on one side of the face.
• Develops weakness of one arm, one leg, or one side of the body.
• Develops sudden problems with speech, vision, or both.
• Is younger than 3 months and has a temperature of 100°F (38°C) or higher.

Summary

• Mastoiditis is an infection that affects the bony area of the skull, behind the ears (mastoid process and mastoid cavity).
• This condition is caused by bacteria.
• Treatment depends on how serious the infection is. It may include antibiotic medicine. Sometimes a procedure is needed to relieve pressure in the ear or to remove infected tissue.
• Follow your child’s health care provider’s instructions about medicines and when to call for help.