Mastoiditis at Red Cross War Memorial Children's Hospital; Cape Town; 1999-2003

During the 5-year period 1999 - 2003; we treated 36 children with a clinical diagnosis of mastoiditis. Post-auricular tenderness; swelling or abscess was the presenting feature in all cases. Twenty of these children had acute mastoiditis; 12 had acute-onchronic mastoiditis and 4 had a post-auricular abscess and no signs of mastoiditis on mastoid exploration (pseudomastoiditis). No pathogenic organisms were cultured from 25of cases overall; but among those with positive culture Streptococcus pyogenes and Staphylococcus aureus were the commonest organisms in the acute mastoiditis group and Proteus mirabilis was the commonest in the acute-on-chronic group. In the acute mastoiditis group (20 patients) only 1 patient was successfully treated with antibiotics; the rest requiring cortical mastoidectomy. In the acute-on-chronic mastoiditis group (12 patients) 9 children had cholesteatoma and underwent an open cavity procedure and the other 3; who underwent cortical mastoidectomy; all had positive histology/culture for tuberculosis

Mastiodite masquée : à propos de deux observations

La mastoïdite masquée (MM) se définit comme un état inflammatoire latent de la muqueuse et de l'os mastoïdien avecun tympan normal. Elle est révélée par une complication généralement endocrânienne. Le traitement est une mastoïdectomie associée à une antibiothérapie intraveineuse.Nous rapportons deux observations de mastoïdites masquées dont le diagnostic a été évoqué par l'examen tomodensitométrique qui a rattaché les complications endocrâniennes à leur origine mastoïdienne. Le but de notre travail est de discuter les circonstances diagnostiques, les investigations paracliniques et le traitementdes mastoïdites masquées