How to Diagnose Mastoiditis

Mastoiditis is any infection of the temporal bone in the skull behind the ear, called the mastoid process. Classic mastoiditis refers to acute disease caused by acute otitis media. Latent mastoiditis is the chronic form and is often caused by the treatment of acute otitis media with antibiotics.

Instructions

• 1

  Observe the characteristic symptoms of mastoiditis. These are most commonly recurring episodes of acute otitis media, fever and pain behind the ear that may be accompanied by a tender mass. Infants with mastoiditis can display nonspecific symptoms such as irritability and poor feeding.

• 2

  Conduct a physical examination for signs of mastoiditis. Common signs of classic mastoiditis include a red, swollen tympanic membrane and mastoid area. Patients with latent mastoiditis may have no external signs.

• 3

  Perform a neurologic examination. The cranial nerves may be involved in the advanced disease, including palsy of the abducens and facial nerves, and pain from the ophthalmic branch of the trigeminal nerve.

• 4

  Make laboratory studies. Blood tests may show leukocytosis and an elevated erythrocyte sedimentation rate. Take fluid from the middle ear if the tympanic membrane is already perforated. A lab technician should make a culture of the fluid and stain it with acid-fast and Gram stains.

• 5

  Search for specific causes of mastoiditis. Common bacterial causes include Streptococcus pneumoniae, Streptococcus pyogenes, Pseudomonas aeruginosa and members of the Staphylococcus species. Other risk factors for mastoiditis include an infected cyst in the middle ear, recurrent acute otitis media and an immunocompromised patient.