A Case of Acute Mastoiditis Progressing to Bezold’s Abscess in an Adult Patient

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  • Bezold膿瘍に進展した成人急性乳様突起炎例
  • 臨床 Bezold膿瘍に進展した成人急性乳様突起炎例
  • リンショウ Bezold ノウヨウ ニ シンテン シタ セイジン キュウセイニュウヨウ トッキエンレイ

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Abstract

<p>Herein, we report a case of Bezold’s abscess in a 55-year-old man with no underlying disease. The patient gave a history of having noticed a swelling behind the left ear about 3 months earlier, but had not sought treatment. He consulted our hospital a few days after the swelling suddenly began to increase in size and became painful. The left postauricular area was red and swollen, with some areas of necrotic skin. The left pinna was seen protruding conspicuously with purulent discharge filling the ear canal, which impeded examination of the eardrum. On computed tomography (CT), the tympanum and mastoid air cells of the left ear were filled with soft tissue shadows, and a subcutaneous abscess was detected, extending from the side of the head to the neck. The diagnosis was acute mastoiditis of the left ear with Bezold’s abscess, and emergency left mastoidectomy and incision and drainage of the abscess on the left side of the neck were performed. Antibiotic therapy was continued postoperatively. Additional mastoidectomy and closure of the surgical wound following the incision and drainage were performed while the patient was hospitalized. The patient was discharged 23 days after the initial surgery.</p><p>Bezold’s abscess of the neck develops as an extracranial complication of otitis media when the pus breaches the mastoid part of the temporal bone via a bone defect. The condition is considered to be common in children and in patients with underlying diseases such as diabetes, but is now rarely encountered. Bezold’s abscess can cause otogenic intracranial complications such as meningitis and brain abscess, if allowed to progress untreated, so that treatment by the appropriate surgical procedure and antibiotic therapy is vital.</p>

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