EP309 - RECURRENT ACUTE MASTOIDITIS AMONG HOSPITALIZED CHILDREN: INCIDENCE AND CHARACTERISTICS (ID 1282)
Abstract
Backgrounds:
Data on pediatric recurrent acute mastoiditis are lacking, despite its morbidity and potential clinical significance. We described the incidence, characteristics, and associated factors of recurrent mastoiditis in hospitalized children.
Methods
Records of children under 18 years, hospitalized with acute mastoiditis in a tertiary pediatric medical center, between June 2011 and December 2017, were analyzed. Recurrent mastoiditis was defined as recurring mastoiditis at least four-weeks after a completely resolved event.
Results:
Of 347 children with acute mastoiditis, 22 (6%) had recurrent mastoiditis; the median interval between episodes was three months (range: 1-36). The mean age was 2.3±2.25 years. Age, sex and history of ear infections did not differ between children with and without recurrent mastoiditis; however, a history of atopic dermatitis was more prevalent among children with recurrent mastoiditis (27.3% vs. 1.2%, p<0.001). The second episode of acute mastoiditis was characterized by a shorter interval between symptom onset and hospitalization (2.8 vs. 5 days, p <0.001) and a milder clinical course. This was evident by a lower rate of fever (24% vs. 65%, p=0.012), a lower platelet count (473 K/micl vs. 550 K/micl, p=0.004); and a shorter duration of intravenous antibiotic therapy and length of hospitalization, (6.6 vs. 10 days, p=0.012 and 6.6 vs. 9.7 days, p=0.022, respectively).
Conclusions/Learning Points:
Children with atopic dermatitis may be at increased risk for recurrent acute mastoiditis. Recurrent episodes of mastoiditis were clinically milder, with shorter hospitalization compared to first episodes, possibly because of earlier hospitalization.
