Mastoiditis is a serious bacterial infection that affects the mastoid bone behind the ear. Without prompt treatment, mastoiditis can potentially lead to meningitis.
Meningitis is a potentially life threatening condition involving inflammation of the membranes that surround and protect the brain and spinal cord.
This article describes how mastoiditis may cause meningitis. It also outlines some common symptoms of both, when to seek medical help, and how doctors treat these conditions.
Yes, in some cases. Meningitis is one of the potential complications of mastoiditis.
Mastoiditis itself occurs when a middle ear infection spreads to a bony compartment behind the ear known as the mastoid process (MP). The infection causes pus to accumulate in tiny air cells within the MP called mastoid air cells.
As pus accumulates, it destroys the mastoid air cells, allowing the infection to spread to tissues deeper inside the skull. If the infection spreads to the protective membranes covering the brain and spinal cord, this may result in meningitis.
A 2024 review describes acute mastoiditis as a serious condition that carries a high risk of health complications, some of which can be fatal without treatment.
In severe cases, untreated mastoiditis may even lead to seizures or death.
However, it is important to note that with prompt treatment,
It is vital to start treatment quickly and to follow all instructions for taking any medications. In particular, a person must still complete their course of antibiotics even if they begin to feel better.
The symptoms of mastoiditis include:
- pain or swelling behind the ear
- ear pain
- hearing loss
- pus or other drainage from the ear
- a bad odor coming from the ear
- protrusion of the ear lobe due to swelling of the mastoid bone
- headache
- fever
- irritability
As the United Kingdom’s National Health Service (NHS) explains, mastoiditis is more common in children and in people who experience severe or repeated ear infections.
The symptoms of meningitis include:
- headache
- fever
- stiff neck
- nausea
- vomiting
- increased sensitivity to light, or photophobia
- confusion
Babies with meningitis can have
- atypical reflexes
- increased sleepiness
- irritability
- poor feeding
- a bulging fontanel, or “soft spot,” on the head
A person should seek medical help immediately if these symptoms develop.
The NHS states that a person should seek medical attention if they experience any of the following:
- an ear infection that persists or worsens despite treatment
- symptoms of mastoiditis
- mastoiditis that persists or worsens despite treatment
Anyone who experiences symptoms of meningitis should seek emergency medical attention. Doing so can help reduce the risk of serious complications, including death.
As the NHS explains, intravenous (IV) antibiotics are the standard treatment for mastoiditis. Individuals receiving IV antibiotics will need to stay in the hospital for 1 to 2 days to ensure that the medication is working. If the symptoms are improving, a doctor may prescribe oral antibiotics that the person can continue taking at home.
If antibiotic treatment does not resolve the condition, however, a person may require additional treatments.
One option is myringotomy. This is a type of surgery that involves making a small incision in the eardrum to help drain pus and to alleviate pressure in the middle ear.
Another option is mastoidectomy. This is a type of surgery that involves removing part of the mastoid bone in order to extract infected mastoid air cells and to drain deep or persistent abscesses.
The
Bacterial meningitis requires immediate treatment with IV antibiotics that are capable of crossing the person’s blood-brain barrier.
Doctors may also prescribe additional treatments, such as anticonvulsant medications to prevent seizures or corticosteroids to reduce brain inflammation, bring down pressure and swelling, and prevent hearing loss.
A mastoid infection that spreads may cause other complications besides meningitis.
As the 2024 review explains, other potential complications of untreated mastoiditis include:
- encephalitis, or inflammation and swelling of the brain
- facial nerve palsy, which causes weakness or paralysis of the muscles on one or both sides of the face
- brain abscess, which is a collection of pus in the brain
- venous sinus thrombosis, which is a blood clot in a vein inside the brain
- deep neck abscess, which is a collection of pus that forms near nerves, blood vessels, and muscles within the neck
Complications of a deep neck abscess can be life threatening and
Mastoiditis is the medical term for infection and inflammation of the mastoid bone behind the ear. Without treatment, the infection can spread to the protective layers surrounding the brain and spinal cord, causing meningitis.
The symptoms of mastoiditis may include pain, swelling behind the ear, and hearing loss. Anyone who experiences these symptoms should contact a doctor for diagnosis and appropriate treatment.
Meningitis may cause additional symptoms, such as headache, fever, and a stiff neck. Meningitis requires immediate and intensive antibiotic treatment in a hospital setting.
Most cases of mastoiditis resolve as long as a person begins antibiotic treatment promptly, completes the antibiotic course, and attends all follow-up appointments with their doctor.