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Mastoiditis is a serious infection that affects the mastoid bone, which is located behind the ear. It can cause a range of symptoms, including ear pain, redness and swelling behind the ear, fever, hearing loss, drainage from the ear, headache, and fatigue. If left untreated, mastoiditis can lead to complications such as meningitis, abscess formation, or even hearing loss. In this article, we will explore the causes, symptoms, diagnosis, and treatment options for mastoiditis.

Causes of Mastoiditis

Mastoiditis is usually caused by a bacterial infection that spreads from the middle ear. The most common bacteria responsible for this infection is Streptococcus pneumoniae, but other bacteria such as Haemophilus influenzae or Staphylococcus aureus can also be involved. The infection typically occurs as a complication of untreated or inadequately treated middle ear infections, also known as otitis media.

Symptoms of Mastoiditis

The symptoms of mastoiditis can vary from person to person, but some common signs to watch out for include:

  • Ear pain: This is often the first symptom experienced by individuals with mastoiditis. The pain can be severe and may worsen with movement or pressure on the affected ear.
  • Redness and swelling behind the ear: The area behind the ear may become red, swollen, and tender to the touch.
  • Fever: Mastoiditis can cause a high fever, usually above 100.4°F (38°C).
  • Hearing loss: As the infection progresses, it can lead to temporary or permanent hearing loss in the affected ear.
  • Drainage from the ear: Pus or fluid may drain from the ear, which can have a foul smell.
  • Headache: Some individuals with mastoiditis may experience headaches, which can be localized or spread throughout the head.
  • Fatigue: The infection can cause general fatigue and malaise.

Diagnosis of Mastoiditis

If you suspect you or your child may have mastoiditis, it is important to seek medical attention promptly. A healthcare professional will perform a thorough examination and may order the following tests:

  • Physical examination: The doctor will examine the affected ear and the area behind it for signs of redness, swelling, or tenderness.
  • Imaging tests: A CT scan or an MRI may be ordered to assess the extent of the infection and to identify any complications.
  • Ear culture: A sample of the fluid draining from the ear may be collected and sent to a laboratory for analysis to determine the specific bacteria causing the infection.

Treatment of Mastoiditis

Mastoiditis is typically treated with a combination of antibiotics and, in some cases, surgical intervention. The specific treatment plan will depend on the severity of the infection and the presence of any complications. Here are the main treatment options:


Antibiotics are the first line of treatment for mastoiditis. They are usually administered intravenously to ensure effective delivery of the medication. The choice of antibiotics will depend on the suspected bacteria causing the infection, as determined by the ear culture. It is important to complete the full course of antibiotics as prescribed by the healthcare professional, even if symptoms improve.


In some cases, surgical intervention may be necessary to drain the infected fluid and remove any abscesses or damaged tissue. This procedure is called a mastoidectomy and is performed under general anesthesia. It involves making an incision behind the ear to access the mastoid bone and remove the infected material. Surgery may also be required if there are complications such as the spread of infection to surrounding structures or the formation of an abscess.

Prevention of Mastoiditis

While it may not always be possible to prevent mastoiditis, there are steps you can take to reduce the risk of developing this infection:

  • Seek prompt treatment for middle ear infections: If you or your child develops symptoms of an ear infection, such as ear pain or fever, seek medical attention promptly. Early treatment can help prevent the spread of infection to the mastoid bone.
  • Complete the full course of antibiotics: If you or your child is prescribed antibiotics for an ear infection, make sure to complete the full course as prescribed by the healthcare professional. This will help ensure that the infection is fully eradicated.
  • Practice good hygiene: Wash your hands regularly and encourage your child to do the same. This can help prevent the spread of bacteria that can cause ear infections.
  • Stay up to date with vaccinations: Vaccines such as the pneumococcal conjugate vaccine and the Haemophilus influenzae type b vaccine can help prevent the bacterial infections that can lead to mastoiditis.

In conclusion, mastoiditis is a serious infection that can cause a range of symptoms, including ear pain, redness and swelling behind the ear, fever, hearing loss, drainage from the ear, headache, and fatigue. Prompt medical attention is crucial to prevent complications and ensure effective treatment. If you suspect mastoiditis, seek medical help immediately. With appropriate antibiotics and, if necessary, surgical intervention, mastoiditis can be successfully treated. Remember to follow preventive measures to reduce the risk of developing this infection. Stay vigilant and prioritize ear health to maintain overall well-being.

Haroon Rashid, MD
Rate author
Urgent Care Center of Arlington, VA
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