Zakażenie Streptococcus pneumoniae jako przyczyna ostrego zapalenia wyrostka sutkowatego u dzieci

Teresa Ryczer¹, *Lidia Zawadzka-Głos¹, Maria Wolniewicz², Agata Kośla², Wojciech Pinkas²

Summary
Introduction. Acute mastoiditis is the most common complication of acute otitis media in children. The treatment consist of surgical management and antibiotic therapy.
Aim. The aim of the study was to present the most important aspects of the management of acute mastoiditis in correlation with microbiological test results.
Material and methods. We did retrospective analysis of clinical data of patients with acute mastoiditis who were hospitalized in the Department of Pediatric Otolaryngology of Medical University of Warsaw between January 2011 and June 2015. The research included the analysis of demographic and clinical data, management, the presence of other complications, and results of microbiological tests.
Results. The study included 50 patients with diagnosis of acute mastoiditis, aged 8 months old-13 years old, with the mean age of 3. The surgical management was applied to 45 (90%) of patients: myringotomy (N = 36, 72%), mastoidectomy (N = 23, 46%). The positive microbiological culture was obtained in 21 patients. The dominant bacteria were Streptococcus pneumoniae and Streptococcus pyogenes. There were 4 cases of antibiotic resistant S. pneumoniae. All patients had antibiotic therapy. Four patients had other intratemporal or/and intracranial complications or/and sepsis.
Conclusions. Acute mastoiditis is still common complication of acute otitis media. The surgical management, which is paracentesis and mastoidectomy, is the key treatment. The modification of antibiotic therapy may be obligatory in case of unsatisfactory clinical improvement or bacterial antibiotic resistancy.

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