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Having mastoiditis and responding to antibiotics. Reffered to ENT for spinal cord infections. What are its implications?
Question: Hey, my daughter is in the local children's hospital with an infection in/behind her mastoid muscle. I think they are calling it cellulitis or mastoiditis. She is responding to antibiotics fairly well, and should be released tomorrow, hopefully. They are referring her to an ENT who specializes in a complication to this, something about spinal cord infections. They say it is rare. What is it, what does it do/implications, and what do we look for to keep this from happening again.
Brief Answer: Eardrum examination, HRCT Temporal Bones, IV meds Detailed Answer: Hi, Thank you for your query. 1. Acute Mastoiditis can be treated with antibiotics. Bone has a poor blood supply (hence deep seated bone infections are difficult to treat) and she is allergic to several antibiotics, besides she may have a resistant infection. She will require IV (Intra Venous) medication. 2. If there is cellulitis or an infection behind the sternocleidomastoid (Bezold's Abscess), it may require surgical drainage if it does not respond to antibiotics or if there is a collection of pus. 3. An HRCT (High Resolution CT) Scan of the Temporal Bones will help differentiate these conditions and also show any spread of the infection beyond the mastoid bone. If you can upload the images, I will be able to give you an accurate assessment. Mastoid X-rays (Schuller's view) would be of limited value here. 4. Request your ENT to get an endoscopic image of the ear drums. This will help the assessment. 5. Complications include the spread of infection beyond the mastoid air cells. Look for pain, fever, swelling behind the ear, decreased hearing, discharge form the ear, vomiting, dizziness, facial or eye paralysis, neck stiffness and altered sensorium. 6. She has a history of Eustachian tube Dysfunction (ETD) and ear tubes in the past. She may have adenoid tissue causing the ETD. Does she snore at night or have mouth breathing? I hope that I have answered your query. if you have any further questions, I will be available to answer them. Regards.
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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