Since the advent of antibiotics and the sulfonamides, acute mastoiditis has become increasingly uncommon as a complication of acute otitis media. In this era with its abundance of easily administered, specific and broad-spectrum antibiotics, it is easy for the physician to use these when fever is the only clinical finding. Antibiotics, however, may mask almost completely the common manifestations of both acute and subacute mastoiditis. The purpose of this report is to present a case of this type. The diagnostic problem was fever of undetermined origin and the infectious disease obscured by antibiotics progressed to abscess formation. The problem of fever of obscure origin will become commoner unless the antibiotic drugs are used more discriminately and specifically and the changes in symptoms of impending serious illness from the classic ones are recognized promptly.
Report of Case
An 8-year-old girl was admitted to the Mayo Clinic on May 9, 1956, because