Case Report

Mastoiditis in an Immunocompetent Adult

Authors: Katharine C. Rathbun, MD, MPH, Mary S. Kendall, MD


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.

Key Points

* 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.

This content is limited to qualifying members.

Existing members, please login first.

If you have an existing account please login now to access this article or view your purchase options.

Purchase only this article ($15)

Create a free account, then purchase this article to download or access it online for 24 hours.

Purchase an SMJ online subscription ($75)

Create a free account, then purchase a subscription to get complete access to all articles for a full year.

Purchase a membership plan (fees vary)

Premium members can access all articles plus recieve many more benefits. View all membership plans and benefit packages.


1. Spiegel JH, Lustig LR, Lee KC, et al. Contemporary presentation and management of a spectrum of mastoid abscesses. Laryngoscope 1998;108:822–828.
2. Tarantino V, D'Agostino R, Taborelli G, et al. Acute mastoiditis: a 10-year retrospective study. Int J Pediatr Otorhinolaryngol 2002;66:143–148.
3. Van Zuijlen DA, Schilder AG, Van Balen FA, et al. National differences in incidence of acute mastoiditis: relationship to prescribing patterns of antibiotics for acute otitis media? Pediatr Infect Dis J2001;20:1012–1013.
4. Linder TE, Briner HR, Bischoff T, Prevention of acute mastoiditis: fact or fiction? Int J Pediatr Otorhinolaryngol 2000;56:129–134.
5. Cheng MF, Chiou CC, Hsieh KS, Mastoiditis: a disease often overlooked by pediatricians. J Microbiol Immunol Infect 2000;33:237–240.