History and symptoms of mastoiditis range from asymptomatic disease to symptomatic and progressive mastoiditis with serious life-threatening complications. History should be taken considering onset, duration, and progression of symptoms, allergies, previous history of acute otitis media, upper respiratory tract infection, associated symptoms (otalgia, fever, confusion), medications including antibiotic usage in acute otitis media, snoring, attendance to day care, history of trauma, co-morbid conditions like diabetes, immunodeficiency, and smoking. Common symptoms of mastoiditis are: ear pain, fever, feeling of “fullness” in the ear, recent episode of acute otitis media, discharge from the affected ear, partial hearing loss, irritability (in infants), headache, and lethargy/malaise. Neurological symptoms from chronic mastoiditis and otitis media with effusion include poor attention span, delayed speech development, clumsiness, and poor balance. Less common symptoms are gastrointestinal symptoms such as vomiting and diarrhea, meningismus, and torticollis.

Obtaining a detailed history is a very important aspect of diagnosis of mastoiditis. It provides insight into the causes, precipitating factors and associated comorbid conditions.

History should be taken considering the following:

• Onset, duration, and progression of symptoms

• Allergies
• Previous history of acute otitis media
• Upper respiratory tract infection
• Associated symptoms (otalgia, fever, confusion)
• Medications, include antibiotic usage in acute otitis media
• Snoring
• Attendance to day care
• History of trauma
• Co-morbid conditions like diabetes or immunodeficiency
• Smoking, which contributes to fluid accumulation and blockage in the eustachian tube
• Smoking during pregnancy
• Occupations involving exposure to air pollution
• Social status^[1][2][3]

Common symptoms of mastoiditis are:

• Ear pain
• Fever
• Feeling of “fullness” in the ear
• Recent episode of acute otitis media
• Fluid discharge in the ear
• Partial hearing loss
• Irritability (in infants)
• Headache
• Lethargy/malaise
• Neurological symptoms from chronic mastoiditis and otitis media with effusion:
  • Poor attention span
  • Delayed speech development
  • Clumsiness
  • Poor balance^[3]

Less common mastoiditis symptoms are:

• Gastrointestinal symptoms such as vomiting and diarrhea
• Meningismus
• Torticollis^[3]