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Incidence of non-infectious ‘acute mastoiditis’ in children

Published online by Cambridge University Press:  28 October 2011

G Kontorinis ,
I Psarommatis ,
C Karabinos ,
Z Iliodromiti  and
M Tsakanikos
G Kontorinis*
Affiliation:
Department of Otorhinolaryngology, Hanover Medical University, Germany
I Psarommatis
Affiliation:
Department of Otorhinolaryngology, P & A Kyriakou Hospital for Sick Children, Athens, Greece
C Karabinos
Affiliation:
Department of Otorhinolaryngology, P & A Kyriakou Hospital for Sick Children, Athens, Greece
Z Iliodromiti
Affiliation:
Department of Neonatology, Aretaieio Hospital, Athens Medical University, Greece
M Tsakanikos
Affiliation:
Department of Otorhinolaryngology, P & A Kyriakou Hospital for Sick Children, Athens, Greece
*
Address for correspondence: Dr Georgios Kontorinis, Department of Otorhinolaryngology, Hanover Medical University, Carl Neuberg Str 1, 30625 Hanover, Germany E-mail: Kontorinis.Georgios@mh-hannover.de
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Abstract

Objective:

The temporal bone may be the first involved site in cases of systemic disease, and may even present with acute, mastoiditis-like symptomatology. This study aimed to evaluate the incidence of such non-infectious ‘acute mastoiditis’ in children.

Materials and methods:

Retrospective chart review of 73 children admitted to a tertiary referral centre for acute mastoiditis.

Results:

In 71 cases (97.3 per cent), an infectious basis was identified. In the majority of cases (33 of 73; 45 per cent), the responsible bacteria was Streptococcus pneumoniae. However, histopathological studies revealed a non-infectious underlying disease (myelocytic leukaemia or Langerhans' cell histiocytosis) in two atypical cases (2.7 per cent).

Conclusion:

‘Acute mastoiditis’ of non-infectious aetiology is a rare but real threat for children, and a challenging diagnosis for otologists. A non-infectious basis should be suspected in every atypical, persistent or recurrent case of acute mastoiditis.

Keywords

ChloromaFacial Nerve ParalysisHistopathologyLangerhans' Cell HistiocytosisLeukaemiaMastoiditis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 126 , Issue 3 , March 2012 , pp. 244 - 248
Copyright
Copyright © JLO (1984) Limited 2011

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References

1Miura, MS, Krumennauer, RC, Lubianca Neto, JF. Intracranial complications of chronic suppurative otitis media in children. Rev Bras Otorrinolaringol 2005;71:639–43CrossRefGoogle ScholarPubMed
2Paparella, MM, Ada, M, Berlinger, N, Fiky, FE. Otological manifestations of leukemia. Laryngoscope 1973;83:1510–26CrossRefGoogle ScholarPubMed
3McCaffrey, TV, McDonald, TJ. Histiocytosis X of the ear and temporal bone: review of 22 cases. Laryngoscope 1979;89:1735–42CrossRefGoogle ScholarPubMed
4Irving, RM, Broadbent, V, Jones, NS. Langerhans' cell histiocytosis in childhood: management of head and neck manifestations. Laryngoscope 1994;104:64–70CrossRefGoogle ScholarPubMed
5Martini, A, Aimoni, C, Trevisani, M, Marangoni, P. Langerhans' cell histiocytosis: report of a case with temporal localization. Int J Pediatr Otorhinolaryngol 2000;55:51–6CrossRefGoogle ScholarPubMed
6Kleinjung, T, Woenckhaus, M, Bachthalter, M, Wolff, JE, Wolf, SR. Langerhans' cell histiocytosis with bilateral temporal bone involvement. Am J Otolaryngol 2003;24:265–70CrossRefGoogle ScholarPubMed
7Druss, J. Aural manifestations of leukemia. Arch Otolaryngol 1945;42:267–74CrossRefGoogle ScholarPubMed
8Gunz, F, Baikie, AG. Leukemia, 3rd edn.New York: Grune and Stratton, 1974;246–7Google ScholarPubMed
9Pochedly, C. Neurological manifestations in acute leukemia. II. Involvement of cranial nerves. In: Pochedly, C, ed. Leukemia and Lymphoma in the Nervous System. Springfield, Illinois: Charles C Thomas, 1977;19–21Google Scholar
10Zappia, JJ, Bunge, FA, Koopmann, CF Jr, McClatchey, KD. Facial nerve paresis as the presenting symptom of leukaemia. Int J Pediatr Otorhinolaryngol 1990;19:259–64CrossRefGoogle Scholar
11Jonas, N, Mulwafu, W, Khosa, S, Hendricks, M. Case study: Langerhans' cell histiocytosis (LCH). Int J Pediatr Otorhinolaryngol Extra 2008;3:61–5CrossRefGoogle Scholar
12Goldsmith, AJ, Myssiorek, D, Valderrama, E, Patel, M. Unifocal Langerhans' cell histiocytosis (eosinophilic granuloma) of the petrous apex. Arch Otolaryngol Head Neck Surg 1993;119:113–16CrossRefGoogle ScholarPubMed
13Zechner, G, Altmann, F. The temporal bone in leukemia histologic studies. Ann Otol Rhinol Laryngol 1969;78:375–87CrossRefGoogle Scholar
14Jiang, CB, Chiu, NC, Hsu, CH, Lee, KS, Shu, MT, Huang, FY. Clinical presentation of acute mastoiditis in children. J Microbiol Immunol Infect 2000;33:187–90Google ScholarPubMed
15Casula, S, Castro, JG, Espinoza, LA. An unusual cause of mastoiditis that evolved into multiple ring-enhancing intracerebral lesions in a person with HIV infection. AIDS Read 2007;17:402–4Google Scholar
16Wuillemin, WA, Vischer, MW, Tobler, A, Fey, MF. Relapse of acute myeloblastic leukaemia presenting as temporal bone chloroma with facial nerve paralysis. Ann Oncol 1993;4:339–40Google ScholarPubMed
17Hermans, R, De Foer, B, Smet, MH, Leysen, J. Eosinophilic granuloma of the head and neck: CT and MRI features in three cases. Pediatr Radiol 1994;24:33–6CrossRefGoogle ScholarPubMed
18Stähelin-Massik, J, Podvinec, M, Jakscha, J, Rüst, N, Greisser, J, Moschopoulos, M et al. Mastoiditis in children: a prospective, observational study comparing clinical presentation, microbiology, computed tomography, surgical findings and histology. Eur J Pediatr 2008;167:541–8CrossRefGoogle ScholarPubMed