From the Guidelines
Mastoiditis is not a common complication of measles. While measles can lead to various complications, particularly respiratory ones such as pneumonia and otitis media (middle ear infection), mastoiditis specifically is not frequently associated with measles infection 1. Mastoiditis, an infection of the mastoid bone behind the ear, typically develops as a complication of untreated or severe otitis media. In the context of measles, the more common ear-related complication is otitis media itself, which can occur, but the exact frequency is not specified in the provided evidence. Key complications of measles include:
- Diarrhea
- Middle ear infection
- Bronchopneumonia
- Encephalitis, which occurs in approximately one of every 1,000 reported cases If a patient with measles develops ear pain, fever, swelling behind the ear, or hearing problems, medical attention should be sought promptly to prevent progression of any ear infection. The immunosuppression caused by measles can make secondary bacterial infections more likely, but modern antibiotic treatment and measles vaccination have significantly reduced the incidence of serious complications in developed countries 1.
From the Research
Mastoiditis and Measles
- There is no direct evidence in the provided studies that links mastoiditis as a common complication in measles.
- The studies focus on the causes, symptoms, and treatment of mastoiditis, primarily as a complication of acute otitis media 2, 3, 4, 5.
- Mastoiditis is described as a serious infection that can lead to severe complications, including intracranial complications 4, 5, 6.
- The most common causative organisms of acute mastoiditis are Streptococcus pneumoniae, Streptococcus pyogenes, and Staphylococcus aureus 2, 4, 5.
Complications of Mastoiditis
- Complications of mastoiditis can be extracranial, intratemporal, or intracranial 2.
- Cerebral venous sinus thrombosis (CVST) is a severe complication of acute mastoiditis, potentially leading to neurological sequelae 6.
- Predictive factors for CVST in children with acute mastoiditis include elevated white blood cell count, C-reactive protein, and neurological symptoms such as headache and vomiting 6.
Treatment and Management
- Antibiotic therapy is the main treatment for acute mastoiditis, with cephalosporins being the antibiotic of choice 2.
- Surgical treatments, such as incision of abscesses and mastoidectomy, may be necessary in severe cases or when medical therapy fails 2, 3.
- Early myringotomy for acute otitis media may decrease the incidence of complications 4.