Post-operative fever in children undergoing mastoidectomy due to
complicated acute mastoiditis
Abstract Objectives: To determine the immediate post-operative course
and outcome of pediatric patients with complicated acute mastoiditis
(CAM) following surgical treatment. Study Design: A retrospective chart
review of children diagnosed with CAM who underwent mastoid surgery
during 2012-2019. Setting: Tertiary care university hospital.
Participants: the study includes 33 patients, divided into two groups:
17 patients with subperiosteal abscess (SPA) alone - single complication
group (SCG) and 16 patients with SPA and additional intracranial or
intratemporal complications -multiple complications group (MCG). Main
Outcome Measures: post-operative fever course and pattern (POF). Results
:33 patients belong to the SCG 17(51%) and 16(49%) belonged to the
MCG, respectively. 6/17(35.3%) SCG patients experienced POF vs.
12/16(75%) in the MCG (P=0.012). At post-operative day 2 (POD2),
10/13(77%) febrile patients belonged to MCG and 3/13(23%) to SCG
(P=0.013). POF was recorded until POD6 in both groups. Seven patients,
all from MCG with POF, underwent second imaging with no new findings.
Conclusion: Following a cortical mastoidectomy for CAM, POF is not
unusual in the first 6 days and seem to be benign condition. POF is more
common, higher, and persistent for a longer duration in MCG compared
with SCG. At POD 6, fever is expected to normalize in both groups, so if
fever persists further evaluation should be considered.