Symptoms of Mastoiditis
Symptoms of Mastoiditis can vary depending on the severity of the infection and how long it has been present. This condition usually develops after untreated or severe middle ear infections. Early signs may be subtle but can progress into more noticeable and serious symptoms. Recognising symptoms of mastoiditis early helps prevent long-term damage and complications. In children, early signs are often mistaken for recurring ear infections, which can delay care. Understanding these symptoms aids timely medical attention.
Pain and Swelling Behind the Ear
One of the earliest signs of mastoiditis is pain behind the affected ear. This pain is usually persistent, throbbing, and worsens over time. The mastoid bone becomes inflamed and tender, causing noticeable swelling. The area may feel warm, firm, or look red and flushed. Severe swelling can push the ear outward or downward.
Children often show pain by tugging at their ear, becoming irritable, or refusing to lie on one side. The skin over the mastoid may appear shiny and tight due to inflammation.
Fever and General Malaise
High fever often accompanies mastoiditis. Temperatures can rise above 38.5°C (101.3°F), with chills and sweating. This shows the body is fighting the infection. Fatigue, weakness, and malaise are also common.
In severe cases, fever may persist despite standard fever-reducing medicine. Fever lasting more than a day or two with ear pain should be checked urgently.
Ear Discharge (Otorrhoea)
Ear discharge is another key symptom of mastoiditis. The fluid may be thick, foul-smelling, or blood-tinged. It usually drains from the ear canal and results from pus building up in the middle ear or mastoid.
Sometimes, pus pressure ruptures the eardrum, releasing fluid. While this may relieve pain temporarily, it indicates a serious stage requiring immediate care. Chronic discharge lasting over two weeks, especially with swelling behind the ear, strongly suggests mastoiditis.
Hearing Loss
Temporary hearing loss is common in mastoiditis. Fluid buildup or middle ear damage often causes this. Sounds may seem muffled or distant. People may need to raise the TV or radio volume.
If untreated, bone erosion or severe damage can cause permanent hearing loss. Children with hearing loss are at risk for delays in speech and communication if not treated promptly.
Irritability, Restlessness, and Poor Feeding in Children
Infants and young children may show behavioural changes rather than verbal complaints. Irritability, excessive crying, refusal to eat, and poor sleep may indicate mastoiditis.
Poor feeding can lead to dehydration and weaken immunity, worsening the infection. Parents should watch for such changes after an ear infection.
Headache and Neck Stiffness
As infection spreads, headaches or neck stiffness may develop. This may result from inflammation of surrounding tissue or, rarely, the brain lining. Any headache, neck stiffness, and fever combination is a medical emergency due to possible meningitis.
Pain may radiate to the side of the head or upper neck, making head movement uncomfortable. These symptoms, along with ear discharge or swelling, should never be ignored.
Tinnitus and Vertigo
Sometimes, mastoiditis affects the inner ear. This can cause tinnitus (ringing) or vertigo (spinning sensation). People may feel dizzy, unsteady, or nauseous.
These symptoms suggest the infection is reaching the vestibular system, which controls balance. Though less common, they indicate a more severe disease and require prompt treatment.
Swollen Lymph Nodes and Facial Swelling
Nearby lymph nodes, especially around the neck and jaw, may swell and feel tender. Facial swelling on the side of the affected ear may also occur.
In rare cases, abscesses form, creating a visible bulge near the ear or neck. Surgery is often needed, and such signs may indicate infection spreading systemically.
Changes in Mental Status (in Severe Cases)
In very severe or neglected mastoiditis, brain involvement may cause confusion, lethargy, disorientation, or seizures. These neurological changes, especially with ear pain or discharge, are medical emergencies.
Early detection and treatment prevent these advanced complications. While uncommon early, these symptoms highlight the importance of vigilance and timely care.
