Wolniewicz Maria, Zawadzka-Głos Lidia, Jadczyszyn Jolanta
Department of Pediatric Otolaryngology, Medical University of Warsaw, Warsaw, Poland.
Otolaryngol Pol. 2025 Jul 2;79(4):1-8. doi: 10.5604/01.3001.0055.1235.
<b>Introduction:</b> Serious intracranial complications of acute mastoiditis seem to be reduced due to vaccine prophylaxis and antibiotics, but recently, after the COVID-19 era, we observe its significant growth.<b>Aim:</b> Due to this observed growth, especially regarding central venous thrombosis, we decided to investigate the patterns of infections within our patients.<b>Materials and methods:</b> We retrospectively analyzed patients hospitalized in our clinic in the years 2018-2022 with the diagnosis of acute mastoiditis. We gathered and analyzed data concerning patients' characteristics and the course of illness. We divided our data into 2 groups: pre- and post-COVID-19-era cases.<b>Results:</b> We found 97 records of 86 patients treated due to acute mastoiditis. As many as 54 cases were classified as pre- and 43 as post-COVID-19 cases. We noted a definite decline in hospitalizations from March 2020 to September 2021 (to 0), which reflects the lockdown period. In the year 2022 we had surprisingly more cases in spring and summer months than in winter. We observed male predominance (p>0.5). Most cases in the pre-COVID group received no treatment before hospitalization in our clinic (p<0.05). We observed higher WBC and CRP levels in the post-COVID group (p<0.05). We found no statistically significant differences in microbiological results between the groups. We found more serious complications in the post-COVID group, with statistical significance only for nerve abducens palsy. We observed a higher need for the use of Vancomycin alone (p = 0.04), mostly as a corrected treatment, or in combination with Ceftriaxone (p = 0.04) in the post-COVID group. The mean time of hospitalization between the 2 groups seems to be similar and was about 13 4 days.<b>Conclusions:</b> We presume that the children's isolation, together with post-infection immunosuppression led to the observed growth of severe complications.
引言：由于疫苗预防和抗生素的使用，急性乳突炎的严重颅内并发症似乎有所减少，但最近，在新冠疫情时代之后，我们观察到其显著增加。
目的：鉴于观察到的这种增加情况，特别是关于中心静脉血栓形成方面，我们决定调查我们患者中的感染模式。
材料和方法：我们回顾性分析了2018年至2022年在我们诊所住院且诊断为急性乳突炎的患者。我们收集并分析了有关患者特征和病程的数据。我们将数据分为两组：新冠疫情时代之前和之后的病例。
结果：我们发现了86例因急性乳突炎接受治疗的患者的97份记录。其中54例被归类为新冠疫情时代之前的病例，43例为之后的病例。我们注意到2020年3月至2021年9月期间住院人数明显下降（降至0），这反映了封锁期。2022年，春季和夏季的病例数比冬季出人意料地更多。我们观察到男性占主导（p>0.5）。新冠疫情时代之前的组中，大多数病例在我们诊所住院前未接受治疗（p<0.05）。我们观察到新冠疫情时代之后的组中白细胞和C反应蛋白水平更高（p<0.05）。我们发现两组之间的微生物学结果没有统计学上的显著差异。我们在新冠疫情时代之后的组中发现了更严重的并发症，仅外展神经麻痹具有统计学意义。我们观察到新冠疫情时代之后的组中单独使用万古霉素的需求更高（p = 0.04），主要作为纠正治疗，或与头孢曲松联合使用（p = 0.04）。两组之间的平均住院时间似乎相似，约为13.4天。
结论：我们推测儿童的隔离以及感染后的免疫抑制导致了观察到的严重并发症的增加。
