Mastoiditis in an Immunocompetent Adult
A 20-year-old white male presented to the family practice department with a 1-month history of right ear pain and loss of hearing. During the month, he had been seen in emergency rooms twice and also by his dentist. He had been treated with pain medications, tooth extraction, and finally, antibiotics. On presentation to the clinic, his right mastoid area showed erythema, tenderness, and swelling that displaced the pinna. He was immediately referred to the otolaryngology department. Imaging studies confirmed coalescent mastoiditis and subperiosteal abscess. He was taken to surgery, where he underwent cortical mastoidectomy and right pressure equalization tube placement. Intraoperative and postoperative intravenous cefotaxime was given. Recovery was complete and uneventful.
* Mastoiditis has become relatively rare, with antibiotic treatment of otitis media.
* Mastoiditis still occurs in immunocompetent patients, both adults and children.
* Mastoiditis should be considered in all severe or intractable cases of ear pain or otitis.
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