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Otitis Externa Posing as Mastoiditis

Robert J. Hopkin, MD; Paul S. Bergeson, MD; Ray C. Pinckard, MD; Karen Lewis, MD
Arch Pediatr Adolesc Med. 1994;148(12):1346-1349. doi:10.1001/archpedi.1994.02170120108022.
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Postauricular cellulitis is commonly associated with mastoiditis and necrotizing otitis externa (NOE). This finding, however, is rarely thought of by pediatricians in conjunction with otitis externa (OE). We have treated several patients with OE who presented with Top, The patient's left pinna is markedly protuberant. Bottom, There is marked erythema and swelling over the mastoid process plus loss of the postauricular skinfolds. postauricular cellulitis over the mastoid process in which the initial diagnosis was incorrect. We describe two patients and discuss clinical features that may differentiate OE, that has extended posteriorly from mastoiditis or NOE.

Patient Reports.Patient 1. An 8-year-old girl was seen with a chief complaint of increasing left ear pain of 7 days' duration. The pain was severe, awakening the patient at night. There were no systemic symptoms, and the patient had no fever. There had been no recent episodes of otitis media. The patient swam frequently


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