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Mastoiditis Differential Diagnoses DDX
Diagnostic Considerations A high index of suspicion, judicious use of diagnostic modalities, and close followup care are recommended to make a diagnosis in a timely manner Conditions to consider in the differential diagnosis of mastoiditis include the following: Basilar Skull Fracture Cellulitis Cysts Deep Neck Infections Lymphadenopathy Parotitis Stroke Trauma Tumors Histiocytoses Sarcoidosis External otitis Mastoid trauma Suppuration of postauricular lymph node Furuncle of meatus of the ear Suppuration of the postauricular (mastoid) lymph node This node collects drainage from the scalp and becomes inflamed with infections involving this region Catscratch disease and atypical mycobacteria tend to have poor response to antimicrobials and a high frequency of nodal abscess formation. Differentiation from acute surgical mastoiditis (ASM) is relatively easy with preservation of the skin crease and presence of a normal middle ear. Lateral sinus thrombosis causes mastoid air sinus abnormalities; this is due to venous congestion as a consequence of this condition.
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