Acute mastoiditis in a child with a history of cochlear implantation : a case report

 Acute mastoiditis is one of the complications of acute otitis media in children. Patients with acute mastoiditis commonly have manifestations of acute otitis media and inflammation of the mastoid bone. Computed tomography is the most frequent diagnostic method for diagnosing acute mastoiditis. In this report, we presented a 6-year-old boy with a history of cochlear implantation three years ago, who was referred for acute swelling and pain in the mastoid bone one day ago. 

 A 6-year-old boy with fever, pain, redness, and swelling of the posterior side of his right ear from one day ago was referred to the clinic. Physical examination showed tenderness, redness, warmness, and swelling on the right auricle and mastoid bone. Implantation in the right ear about three years ago was mentioned. Last week, involvement with coryza, nasal congestion, and low-grade fever without ear pain was mentioned. Acute mastoiditis was confirmed with CT scanning, and he was cured with antibiotic therapy.

 Acute mastoiditis is not common. It may occur after a few times of cochlear implantation, but it occurs rarely after a long time. The main cause is bacterial infection. After confirmation of the diagnosis with CT scanning, treatment with antibiotics should be started intravenously, and then it can be changed to oral antibiotics.    

 Acute mastoiditis should be considered as a differential diagnosis in pediatrics with acute swelling, pain, and any manifestation of inflammation on mastoid bone, even though there is no history of acute otitis media.