Mastoiditis Differential Diagnoses

Updated: Jan 14, 2022
  • Author: PP Devan, MBBS, MS; Chief Editor: Arlen D Meyers, MD, MBA  more...
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Diagnostic Considerations

A high index of suspicion, judicious use of diagnostic modalities, and close follow-up 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.

Differential Diagnoses

  • Bell Palsy

  • Otitis Externa

  • Otitis Media

  • Wegener Granulomatosis