Recent reports indicate an increase in the incidence of acute mastoiditis due to Fusobacterium Necrophorum. In addition, this pathogen is associated with an increased rate of complications. The aim of this study was to validate these observations and identify clinical and laboratory characteristics that will aid clinicians in the diagnosis of F.Necrophorum in order to initiate early appropriate treatment.
We examined all mastoiditis cases in Schneider Children`s Medical Center between the years 2011-2015. During the study period 262 infants and children were diagnosed with acute mastoiditis. F.Necrophorum was identified in 19 (7.2%) cases. The incidence of F.Necrophorum acute mastoiditis increased over time, from 1.7% in 2012 to 12% in 2015. It was associated with higher fever values on admission (median 40oC vs. 39oC in non- F.Necrophorum cases, p=0.005), higher rate of antibiotic treatment prior to admission (63.2% vs. 28.8%, p<0.01), higher CRP values on admission (median 22.85 mg/dl vs. 7.93 mg/dl, p<0.001) and a higher rate of complications (84.2% vs. 10.7%, p<0.001).
Clinicians should be aware of the uprising incidence rates of F.Necrophorum acute mastoiditis as these cases necessitate different management. They are associated with significant clinical complications. Anaerobic cultures and empirical treatment including anaerobic coverage should be considered in high risk patients, as defined above.
