Background: Mastoiditis, a common complication of acute otitis media (OM), is a significant concern for pediatric otolaryngologists, with an incidence of 1-6 cases per 100,000 children annually. While most cases are caused by common pathogens such as Streptococcus pneumoniae and Staphylococcus aureus, Mycobacterium abscessus (M. abscessus), a rapidly growing nontuberculous mycobacterium,