Severe Acute Otitis Media and Acute Mastoiditis in Adults

“…Laulajainen Hongisto et al studied 167 adults with AOM and found intracranial complications in 13% of the population 9. In contrast to our case, Leskinen et al studied 50 adults with AOM retrospectively and found that intracranial complications were common with patients with ear symptoms of prolonged duration (more than 7 days) 10…”

“…In previous publications, there are no major differences in AOM/AM hospitalization times between different pathogens, but the hospitalization for S. pneumoniae was the longest. 21 The patients' hearing recovery was unexpectedly good, considering the SNHL at presentation (Figures 2 and 3; Table 4). Although most patients reported being relatively asymptomatic at their followup visit, they did have some residual symptoms as measured by the EOS-16 after 1.5 to 3 years.…”

“…Whether or not the tympanomastoidectomy was performed had no effect on the time of hospitalization. 20,21 Patients without mastoiditis had a shorter hospitalization period. In previous publications, there are no major differences in AOM/AM hospitalization times between different pathogens, but the hospitalization for S. pneumoniae was the longest.…”

“…In our case, the duration of symptoms was 4 days. Retrospective studies on acute mastoiditis (AM) publicize that half of the cases in Italy presented with symptoms for only 1– 3 days ( 17 ), whereas the mean duration of acute symptoms in Finland was 12.5 days ( 14 ), and Australian children under 16 diagnosed with AM had a mean symptom duration of 10.3 days prior to presentation ( 18 ) and a study in Greece found that the mean duration of AOM symptoms before presentation was 6.1 days, and the average interval from the onset of AM to presentation was 1.5 days ( 19 ). Our patient’s presentation falls within this range, supporting findings that AM onset does not always follow a prolonged course in immunocompromised patients.…”

“…A review of the literature on LAD patients with AM revealed the isolation of pathogens such as Streptococcus pneumoniae and Haemophilus influenzae ( 5 ), Staphylococcus aureus ( 23 ), and Pseudomonas aeruginosa ( 20 ). Literature shows high rates of negative culture results in AM patients, ranging from 13% to 67% across different studies ( 14 , 15 , 17 , 19 , 26 ). In our case, consistent with the literature, we believe that the absence of growth in the intraoperative mastoid tissue culture was attributable to the patient being operated on while receiving antibiotic therapy.…”