12 yr old boy - samomcos

[ArchivalUser]

3

[ArchivalUser]

sorry i will also change my answer its 5
coz it looks like external ear infection and mastoiditis usually occurs with middle ear infec.


one more thing if the discharge was granulomatous then we got to rule out cholesteatoma( a tumor which eats up the bone) and if in diabetic think of psuedomonas
correct me if i am wrong

[ArchivalUser]

33333

¢Plain radiographs may show increased opacification in the mastoid region; radiography is not a reliable study for evaluation of mastoiditis.

¢CT scan may show fluid collection in the middle ear and mastoid region, abscess formations, or demineralization of the mastoid trabeculae. Some argue that all suspected cases of mastoiditis warrant CT evaluation. CT scan is considered a reliable evaluation of mastoiditis

MRI may be useful for detailed evaluation of contiguous soft tissue, vascular structures, extra-axial fluid collections, differentiation of tumors, and inflammatory processes. However, MRI is not as applicable as CT in the ED setting.Acute mastoiditis with extracranial or intracranial complications is usually treated with intravenous antibiotics

Intravenous treatment should be continued for 7 to 10 days, after which oral antimicrobial therapy can be substituted if the clinical response to treatment has been satisfactory. The total duration of antimicrobial therapy is four wk

[ArchivalUser]

¢Plain radiographs may show increased opacification in the mastoid region; radiography is not a reliable study for evaluation of mastoiditis.

¢CT scan may show fluid collection in the middle ear and mastoid region, abscess formations, or demineralization of the mastoid trabeculae. Some argue that all suspected cases of mastoiditis warrant CT evaluation. CT scan is considered a reliable evaluation of mastoiditis with published sensitivities that range from 87-100%.5 ¢

MRI may be useful for detailed evaluation of contiguous soft tissue, vascular structures, extra-axial fluid collections, differentiation of tumors, and inflammatory processes. However, MRI is not as applicable as CT in the ED setting.

These agents should cover the empiric organisms that cause mastoiditis. A third-generation cephalosporin or the combination of a penicillinase-resistant penicillin and an aminoglycoside is recommended. If a patient is allergic to penicillin (history of anaphylaxis), clindamycin can be considered instead of penicillins. If Pseudomonas species is suspected, an antipseudomonal penicillin should be used.

After identification of the organism, antibiotic coverage can be narrowed. Patients should be afebrile for 48 hours before intravenous antibiotics are discontinued. Oral antibiotics should then be administered for an additional 14 days

[ArchivalUser]

ans is 3 - CT to look for matoiditis in which case u need to start the patient on IV antibiotics and maybe do mastoidectomy.