Infectious Disease Compendium



Infection of the mastoid, often follows otitis media.

Epidemiologic Risks

If > age 2 you have a mastoid; often follows URI's.


Acute: S. pneumoniae, H. influenzae.

Chronic: S. aureus and gram-negative enteric bacilli.

Atypical mycobacteria are not uncommon, presenting with refractory otorrhea and lots of granulation tissue and are best treated with surgery (PubMed)

Empiric Therapy

Acute: amoxicillin OR amoxicillin/clavulanate OR doxycycline OR tmp/sulfa OR second generation cephalosporins such as cefuroxime.

In other words; damn near anything will work.

Chronic: it is best to let cultures be you guide; treating empirically is path down which lies madness.


Occasionally will be the source of a cerebellar abscess.

Curious Cases

Relevant links to my Medscape blog

What's Past is Prologue