{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:07:42Z","timestamp":1764547662767,"version":"3.46.0"},"reference-count":16,"publisher":"AACN Publishing","issue":"6","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,1]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Mastoiditis is a major complication of acute otitis media that, if left undiagnosed or untreated, can lead to meningitis. This case report shares the clinical course of a child with acute mastoiditis. The related discussion provides an overview of acute mastoiditis, including its presenting signs and symptoms, diagnostic testing, treatment, and outcome and prognosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Clinical Findings and Diagnosis<\/jats:title>\n                    <jats:p>A 9-year-old male patient presented with fever, symptoms of a viral upper respiratory infection, and tachycardia. His physical examination was remarkable for muscle hypotonia, asymmetrical pupils, and incomprehensible speech. Laboratory testing and imaging confirmed Streptococcus pneumoniae meningitis, acute mastoiditis, and hydrocephalus.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Interventions<\/jats:title>\n                    <jats:p>Within hours of admission, the patient\u2019s neurologic status deteriorated, requiring intubation and emergent ventriculostomy with external ventricular drain placement. Once he was stabilized, a right mastoidectomy with myringotomy tube placement was performed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Patient Outcome<\/jats:title>\n                    <jats:p>Ultimately, the patient underwent ventriculoperitoneal shunt placement and, after a 5-month hospitalization, had significant neurologic delays for which he received aggressive inpatient rehabilitation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This case report and condition review highlight the importance of assessing for acute otitis media and recognizing early signs and symptoms of mastoiditis in all children to minimize disease progression and associated morbidity and mortality.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4037\/ccn2025595","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:03:24Z","timestamp":1764547404000},"page":"22-26","source":"Crossref","is-referenced-by-count":0,"title":["Acute Mastoiditis Complicated by Meningitis: A Case Report and Condition Overview"],"prefix":"10.4037","volume":"45","author":[{"given":"Amy K.","family":"Sedgwick","sequence":"first","affiliation":[{"name":"Amy Sedgwick is a pediatric critical care transport registered nurse at Mount Sinai Kravis Children\u2019s Hospital, New York, New York. She is enrolled in the Dual Pediatric Primary\/Acute Care BS to DNP Nurse Practitioner Program at Rutgers School of Nursing."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sharon","family":"Anderson","sequence":"additional","affiliation":[{"name":"Sharon Anderson is an associate professor in the Division of Advanced Nursing Practice at Rutgers School of Nursing, Newark, New Jersey. She is an advanced practice nurse at Rutgers Health, Division of Medical Genetics, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2471","reference":[{"issue":"6","key":"2025113019031551200_b1-0450022","doi-asserted-by":"publisher","first-page":"906","DOI":"10.24953\/turkjped.2023.320","article-title":"A scoping review of the management of acute mastoiditis in children: what is the best approach?","volume":"65","author":"Di Sarno","year":"2023","journal-title":"Turk J Pediatr"},{"key":"2025113019031551200_b2-0450022","doi-asserted-by":"publisher","first-page":"109675","DOI":"10.1016\/j.ijporl.2019.109675","article-title":"Clinical outcomes of intracranial complications secondary to acute mastoiditis: the Alder Hey experience","volume":"128","author":"Krishnan","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"4","key":"2025113019031551200_b3-0450022","doi-asserted-by":"publisher","first-page":"104299","DOI":"10.1016\/j.amjoto.2024.104299","article-title":"Intracranial complications of acute mastoiditis: surgery not always necessary","volume":"45","author":"Shinnawi","year":"2024","journal-title":"Am J Otolaryngol"},{"issue":"9","key":"2025113019031551200_b4-0450022","doi-asserted-by":"publisher","first-page":"469","DOI":"10.12788\/jfp.0094","article-title":"Increasing ear pain and headache","volume":"69","author":"Tambunan","year":"2020","journal-title":"J Fam Pract"},{"issue":"5","key":"2025113019031551200_b5-0450022","doi-asserted-by":"publisher","first-page":"103520","DOI":"10.1016\/j.amjoto.2022.103520","article-title":"Epidemiology and variability in the management of acute mastoiditis in children","volume":"43","author":"Edwards","year":"2022","journal-title":"Am J Otolaryngol"},{"issue":"2","key":"2025113019031551200_b6-0450022","doi-asserted-by":"publisher","first-page":"e35113","DOI":"10.7759\/cureus.35113","article-title":"The development of bilateral mastoiditis following acute otitis media in a pediatric patient with limited access to health care","volume":"15","author":"Telatin","year":"2023","journal-title":"Cureus"},{"issue":"suppl 1","key":"2025113019031551200_b7-0450022","doi-asserted-by":"publisher","first-page":"54","DOI":"10.23750\/abm.v91i1-S.9259","article-title":"Acute mastoiditis in children","volume":"91","author":"Cassano","year":"2020","journal-title":"Acta Biomed"},{"issue":"1","key":"2025113019031551200_b8-0450022","doi-asserted-by":"publisher","first-page":"50","DOI":"10.5152\/iao.2023.22794","article-title":"Analysis of prognostic factors impacting pediatric acute mastoiditis outcomes","volume":"19","author":"Israeli","year":"2023","journal-title":"J Int Adv Otol"},{"issue":"1","key":"2025113019031551200_b9-0450022","doi-asserted-by":"publisher","first-page":"e14","DOI":"10.1097\/INF.0000000000002049","article-title":"National incidence of pediatric mastoiditis in the United States, 2000\u20132012: creating a baseline for public health surveillance","volume":"38","author":"King","year":"2019","journal-title":"Pediatr Infect Dis J"},{"key":"2025113019031551200_b10-0450022","doi-asserted-by":"publisher","first-page":"187","DOI":"10.1016\/j.ijporl.2019.07.014","article-title":"Acute mastoiditis: 20 years of experience with a uniform management protocol","volume":"125","author":"Mansour","year":"2019","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"4","key":"2025113019031551200_b11-0450022","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1097\/INF.0000000000000138","article-title":"Incidence of acute mastoiditis in Colorado children in the pneumococcal conjugate vaccine era","volume":"33","author":"Halgrimson","year":"2014","journal-title":"Pediatr Infect Dis J"},{"key":"2025113019031551200_b12-0450022","doi-asserted-by":"publisher","first-page":"111611","DOI":"10.1016\/j.ijporl.2023.111611","article-title":"Surgical management of mastoiditis with intratemporal and intracranial complications in children: outcome, complications, and predictive factors","volume":"171","author":"Guill\u00e9n-Lozada","year":"2023","journal-title":"Int J Pediatr Otorhinolaryngol"},{"key":"2025113019031551200_b13-0450022","doi-asserted-by":"publisher","first-page":"110372","DOI":"10.1016\/j.ijporl.2020.110372","article-title":"Our experience on the management of acute mastoiditis in pediatric acute otitis media patients","volume":"138","author":"Duygu","year":"2020","journal-title":"Int J Pediatr Otorhinolaryngol"},{"issue":"3","key":"2025113019031551200_b14-0450022","doi-asserted-by":"publisher","first-page":"e964","DOI":"10.1542\/peds.2012-3488","article-title":"The diagnosis and management of acute otitis media","volume":"131","author":"Lieberthal","year":"2013","journal-title":"Pediatrics"},{"key":"2025113019031551200_b15-0450022","unstructured":"Johns Hopkins All Children\u2019s Hospital\n          . 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