Acute mastoiditis is commonly attributed to infection. Rarely do clinicians encounter cases that do not respond to traditional antibiotics or surgical management.

The goal of this study was to systematically review the literature to characterize diseases masquerading as acute infectious mastoiditis.

A systematic review was performed to identify all publications that reported on diseases with presentations mimicking acute mastoiditis, defined as postauricular redness, swelling, and tenderness.

We included clinical prospective studies, retrospective studies, and case series/reports.

Exclusion criteria included non-English articles, letters/commentaries, abstracts, and review articles.