Mastoiditis, a serious complication of acute otitis media, primarily affects the pediatric population and requires prompt diagnosis and treatment to prevent severe complications. This review explores the pathophysiology, clinical presentation, diagnostic techniques, and therapeutic approaches for mastoiditis, focusing on the role of amoxicillin in its management. The anatomical connection between the middle ear and mastoid air cells facilitates the spread of infection, which is further influenced by inflammatory processes, bacterial biofilms, and host immune responses. Diagnosis involves a combination of clinical findings, imaging studies such as computed tomography and magnetic resonance imaging, and microbiological cultures to guide targeted antibiotic therapy. Amoxicillin remains the first-line treatment for non-resistant cases owing to its effectiveness against common pathogens, safety profile, and cost efficiency. However, the increasing prevalence of β-lactamase-producing bacteria necessitates the use of amoxicillin-clavulanate in resistant cases. Antibiotic selection should be based on local resistance patterns and patient-specific factors, such as allergies and comorbidities. Surgical interventions, including mastoidectomy, are required in advanced or refractory cases. Future research should focus on developing novel diagnostic tools, optimizing antibiotic regimens, and implementing antimicrobial stewardship programs to combat drug resistance. Global collaboration is essential for establishing standardized guidelines and improving access to high-quality care in resource-limited settings.

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Mixed Medullary and Follicular Cell Carcinoma (MMFCC) is a rare thyroid cancer combining medullary and follicular (often papillary) elements. The lack of standard clinical signs and imaging characteristics makes it difficult to diagnose before surgery. At present, the main approach to treatment is surgical removal, and the outlook for patients is primarily influenced by how advanced the medullary carcinoma is. We report two cases of MMFCC confirmed by postoperative pathology. Case 1 involved a 46-year-old woman with bilateral thyroid nodules and left cervical lymph node metastasis. Preoperative ultrasound classified the nodules as TI-RADS 4c, and fine-needle aspiration cytology suggested papillary thyroid carcinoma. Total thyroidectomy with bilateral neck lymph node dissection was performed. Postoperative pathology revealed MMFCC, with a medullary component accounting for approximately 95% and extensive lymph node metastasis. Six weeks postoperatively, serum calcitonin was 73.00 pg/mL. Case 2 involved a 54-year-old man presenting with neck pain. Ultrasound showed a hypoechoic left thyroid nodule (TI-RADS 4b) with bilateral cervical lymphadenopathy. Fine-needle aspiration suggested medullary thyroid carcinoma, and serum calcitonin and carcinoembryonic antigen levels were markedly elevated. Following total thyroidectomy with bilateral neck lymph node dissection, pathology confirmed MMFCC with an approximately 80% medullary component. Postoperative tumor markers decreased significantly, and long-term follow-up was initiated. MMFCC is a rare thyroid carcinoma with considerable diagnostic difficulty. Fine-needle aspiration alone may be insufficient for accurate diagnosis, whereas preoperative serum calcitonin testing provides important diagnostic clues. Total thyroidectomy with systematic lymph node dissection is advised, plus long-term monitoring per both carcinoma guidelines.

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