Bezold's Abscess
Overview
A Bezold's abscess is a complication of mastoiditis where the mastoid infection erodes through the cortical surface of the mastoid bone and forms a secondary abscess pocket near the attachment of the sternocleidomastoid (SCM) muscle.[1]
History
Bezold's abscess is named after Friedrich Bezold, a German otologist that first described it in 1881.[2]
Pathophysiology
Relevant Anatomy
Bezold's abscess is an extension of mastoiditis into the neck space deep to the mastoid attachment of the sternocleidomastoid muscle.
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Transected view of the mastoid bone.
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Inferior view of the mastoid bone.
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Attachment of the sternocleidomastoid muscle to the mastoid bone.
Disease Etiology
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Diagnosis
Patient History
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Physical Examination
Patients can experience the following symptoms:[3]
- Neck pain
- Neck stiffness
- Dysphagia
- Otalgia
- Otorrhea (in the setting of a perforated tympanic membrane)
Physical exam can reveal the following findings:
- Neck swelling
- Auricular proptosis
- Mastoid swelling
- Mastoid tenderness
- Fever
Laboratory Tests
Laboratory tests should primarily focus on your typical infectious workup:
- CBC
- CRP / ESR
- Blood cultures
- Gram stain and culture of otorrhea (if present)
Imaging
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Management
Medical Management
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Surgical Management
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Outcomes
Complications
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Prognosis
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References
- ↑ Marioni, G., de Filippis, C., Tregnaghi, A., Marchese-Ragona, R., & Staffieri, A. (2001). Bezold's abscess in children: case report and review of the literature. International journal of pediatric otorhinolaryngology, 61(2), 173-177.
- ↑ Bezold, F. (1881). Ein neuer Weg für Ausbreitung eitriger Entzündung aus den Räumen des Mittelohrs auf die Nachbarschaft und die in diesem Falle einzuschlagende Therapie. DMW-Deutsche Medizinische Wochenschrift, 7(28), 381-385.
- ↑ Gaffney, R. J., O'Dwyer, T. P., & Maguire, A. J. (1991). Bezold's abscess. The Journal of Laryngology & Otology, 105(9), 765-766.