Subacute (masked) mastoiditis — Clinical features of include fever, cough, ear pain, and tympanic membrane findings compatible with AOM. Subacute mastoiditis occasionally presents with an extracranial or intracranial complication without signs of AOM or mastoiditis.

Subacute mastoiditis should be considered in children with AOM that is not responding to antibiotics and in children with signs of intracranial infection without another focus of infection.

Subacute Otitis media has to be Diagnosed with CT scan. If you suspect regular mastoiditis you may forego CT scan and do tympanocentesis.

Amoxicillin course has not resolved pain + down/lateral displacement of auricle = abscess symptoms... use CT to visualize

acute otitis media that became mastoiditis (downward and lateral displacement of the auricle) as well as irritability; according to some algorithms, CT is used as the next step for complicated mastoiditis (whereas tympanometry and tympanocentesis are not)