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Year : 2016  |  Volume : 22  |  Issue : 3  |  Page : 148-151

Bezold's abscess: A case report and review of cases over 14 years

Department of Otolaryngology, Qatif Central Hospital, Eastern Province, Saudi Arabia

Correspondence Address:
Hussain Al-Baharna
4568 Mahmud Al Warraq Street, Al Qatif 32631-7047, Eastern Province
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0971-7749.187978

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Bezold's abscess is one of the rare complications of otitis media. It was named after Friedrich Bezold in 1881, who described the pus escaping through the medial side of the mastoid process into the incisura digastrica (digastric grove) and forming an abscess. This article reports a case report of a 73-year-old male who presented with right otitis media complicated with Bezold's abscess. The diagnosis is confirmed radiologically by magnetic resonance imaging. The patient was managed by intravenous antibiotic, drainage of abscess, and cortical mastoidectomy. Then, we conducted a literature review for all the cases reported between 2000 and 2014. We found around 17 cases in the literature, and additional eight reported cases but we have excluded them because some are not in English language and the others are not registered in PubMed. We think that because of the evolution in imaging technology, these cases are easier to be diagnosed nowadays. Bezold's abscesses case reports were seen more in adults (10 of 18, 55.6%) than in pediatric of 18 years old and below (8 of 18, 44.4%). It is found more in males (11 of 18, 61%) than in females (7 of 18, 39%). In this review, the time latency between the presentation of the patient and the diagnosis of Bezold's abscess is ranging between 2 days and 2 weeks. The pattern of mastoid pneumatization is the main factor behind developing Bezold's abscess. Since this review confirms that the most common organisms are Gram-positive organisms, it is wise to choose the antibiotic directed against Gram-positive organisms. Finally, we conclude that the surgical treatment can be tailored according to the pneumatization of the mastoid bone and the extension of neck abscess.

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