Mastoiditis: Acute

Clinical Pathways promote evidence-based, safe, and high-value patient care by providing clinical recommendations and standard processes. They are developed by multidisciplinary committees of subject matter experts, informed by a methodical review of available evidence and consensus among committee members.

Clinical Pathway: 

• Mastoiditis: Acute Algorithm 
• Acute Mastoiditis Synopsis (provides care standards employed for this clinical pathway) 

Inclusion and exclusion criteria: 

• Inclusion: 
  • Patients with signs or symptoms concerning for acute mastoiditis (e.g., auricular protrusion and/or postauricular fluctuance, tenderness, edema, with or without erythema)  
• Exclusion:  
  • Patients who are immunocompromised (contact the Immunocompromised Infectious Diseases Physician on call)
  • Patients with imaging-only temporal bone changes in the absence of clinical signs of mastoiditis 
  • Patients with known trauma 

 Committee members involved in the development: 

• Maria (Pachi) Deza Leon, MD | Infectious Diseases | Committee Co-Chair 
• Jill Arganbright, MD | Otolaryngology (Ear, Nose, and Throat) | Committee Co-Chair 
• Joan Magee, BSN, RN, CPN | Comprehensive Otology and Hearing Program | Committee Member  
• Theodore Barnett, MD | Pediatric Emergency Medicine | Committee Member  
• Katlyn Mayer, MD | Pediatric Emergency Medicine Fellow | Committee Member  
• Marina Dantas, MD, MSCR | Hospital Medicine | Committee Member  
• Meghan Bullock, DNP, CPNP-AC | Hospital Medicine | Committee Member  
• Paige Haynes, MD | Neurosurgery | Committee Member  
• Mike Puricelli, MD | Otolaryngology (Ear, Nose, and Throat) | Committee Member 
• Alaina Burns, Pharm.D., BCPPS | Pharmacy | Committee Member  
• Sarah Dierking, MSN, RN, CPHQ | Clinical Practice and Quality | Committee Member  

 EBP Committee Members: 

• Kathleen Berg, MD, FAAP | Evidence Based Practice  
• Kelli Ott, OTD, OTR/L | Evidence Based Practice  

 Publication dates: 

• Finalized date: 06/2026 
• Next expected revision date: 06/2029 

Concerns with content: 

If you have any questions regarding this content or identify a broken link, please email evidencebasedpractice@cmh.edu.  

These pathways do not establish a standard of care to be followed in every case. It is recognized that each case is different, and those individuals involved in providing health care are expected to use their judgment in determining what is in the best interests of the patient based on the circumstances existing at the time. It is impossible to anticipate all possible situations that may exist and to prepare a pathway for each. Accordingly, these pathways should guide care with the understanding that departures from them may be required at times.