Mastoiditis physical examination

Acute mastoiditis patients are usually ill-appearing and usually present with low-grade fever. Patients with complicated mastoiditis may appear severly ill. Mastoiditis physical examination findings include posterior auricular signs such as postauricular swelling, erythema, tenderness, protrusion of pinna, and sagging external ear canal. Otoscopic examination findings include erythema, bulging, cloudy appearance, and immobility of the tympanic membrane.

Patients with mastoiditis may present with some or all of the following signs:^{[1][2][3][4][5]}

Patients with mastoiditis usually appear ill and have marked inflammation and edema of the periauricular area.

Patients with mastoiditis may have the following vital signs, which are suggestive of infection:

• Fever
• Hypotension
• Tachycardia
• Tachypnea

Patients with mastoiditis may present with the following skin findings:

• Erythema of the periauricular skin
• Edema of the periauricular skin

Patients with mastoiditis may have the following HEENT findings on physical examination:

Patients with mastoiditis may present with the following signs:

• Evidence of recent eye trauma
• Evidence of recent insect bites

Patients with mastoiditis may present with the following signs:

• Otorrhea
• Postauricular swelling
• Postauricular erythema
• Postauricular tenderness
• Protrusion of pinna
• Sagging external ear canal
• Blurred tympanic membrane

Mastoiditis patients may present with signs that are suggestive of inner or middle ear infection:

• Erythema, edema, and discharge present on otoscopy
• Hearing loss
• Children may show signs of “tugging” on the affected ear

Patients with mastoiditis may present with signs which are suggestive of oral, pharyngeal, or upper respiratory tract infections:

• Erythematous oropharynx
• Exudative tonsils
• Dental caries
• Tooth abscess

Patients with mastoiditis may present with tender cervical lymph nodes, which are suggestive of regional infection.

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