Prevalence of Mastoiditis in Children Hospitalized in the Last 16 Years in a Teaching Hospital Alcides Carneiro - Rio de Janeiro - Brazil

Background: Acute Mastoiditis is defined as inflammation/infection of the aerated cells of the mastoid process of the temporal bone, being the most frequent evolutionary course of Acute Otitis Media. The pediatric age group is particularly more susceptible to the sequel and complications inherent to the course of this pathology. According to the literature, its prevalence in the last years remains stable, the average age is below 4 years, there is predilection for the male sex and complications are associated with high leukocyte count and high values ​​of C-reactive protein (CRP).

Objective: To identify common characteristics in children hospitalized HEAC for Acute Mastoiditis in the period 2001-2017.

Methods: Retrospective, cross-sectional, quantitative, descriptive study of Acute Mastoiditis cases occurred in the last 16 years in HEAC Pediatrics. Variables analyzed: sex, age, hospital stay, comorbidities, complications, therapeutics, complementary exams and outcome.

Results: Total hospitalizations during the study period: 17,058. Hospitalizations for acute mastoiditis: 24 (0.14%). Averages: Age 5.1years; Length of stay: 14days; Antibiotic therapy: 25days. Complications: 6 (50% tympanic perforation); 100% initial diagnosis of Otitis Media. Leukocytosis 71.42% and increased CRP in 64.2%. Surgical approach: 1 (7.4%). Initially the most used empirical antibiotic therapy: Ceftriaxone (21.4%) and Ceftriaxone + Oxacillin (21.4%). Terminal monotherapy: Ceftriaxone in 28.57%. Antimicrobial therapy maintained at 42.85%, followed by completion with Amoxicillin+Clavulanate 21.4%. Computed tomography: 71.42%. Good evolution: 95.83%.

Conclusion: In contrast to the world literature, the majority of cases progressed satisfactorily with the use of antibiotic monotherapy, only one case required surgical resolution, we did not find gender preference and the mean age was higher than expected. Although we find low prevalence of complications and inadequate outcome, it is necessary to strictly comply with the diagnostic and therapeutic protocols of this and other pathologies in order to minimize sequel and serious complications for the future of our small patients.