An Unusual Complication of Chronic Suppurative Otitis Media: Bezold Abscess Progressing to Scapular Abscess

Abstract

Introduction Suppurative otitis media is still the most common ear disease in developing countries. Otogenic complications of this disease have decreased considerably because of the advent of antibiotics, and few rare complications have been encountered. Objective To report a case of a patient with scapular abscess and lumber cellulitis that had progressed from Bezold abscess as a complication of squamous-type chronic suppurative otitis media. Resumed Report A 14-year-old girl presented with foul-smelling, purulent, left ear discharge of 1-year duration and decreased hearing on same ear of 6-month duration. She developed painful swelling in left side of neck with restricted neck movement and high-grade fever of 3-day duration and swelling over the left scapular area of 1-day duration. The examination and investigation diagnosed squamous-type chronic suppurative otitis media with Bezold abscess progressing to scapular abscess and lumber cellulitis. Final Comment Chronic suppurative otitis media can lead to abscess in any part of body.

Fatal cervicomediastinal necrotising fasciitis due to cholesteatoma

“…In 1881, Friedrich Bezold first described deep cervical infection of otogenic origin, with a case of suppuration extending into the digastric groove secondary to acute mastoiditis. There are previous reports of Bezold abscess spreading inferiorly along fascial planes of the neck, to form anterior chest wall, scapular or parapharyngeal abscesses, however this is the first case in the English literature to report cervical necrotising fasciitis due to ear disease …”

“…There are previous reports of Bezold abscess spreading inferiorly along fascial planes of the neck, to form anterior chest wall, scapular or parapharyngeal abscesses, however this is the first case in the English literature to report cervical necrotising fasciitis due to ear disease. [6][7][8][9] Chronic otitis media has been identified as a significant public health problem in South East Asia, where few countries have the capacity to consistently offer surgical therapy. 10 In Cambodia, health expenditure is primarily borne by the patient, which, in a predominantly rural and low-income population, often results in delayed presentation to medical care.…”

Simultaneous Coexistence of Complications of Chronic Otitis Media in the Same Case

“…There are few reported cases of further extension of Bezold abscess into other regions of the body [8,9] . Pradhananga discriminated a 14-year-old girl with scapular abscess secondary to Bezold abscess [8] , Singh et al [9] declared a case of Bezold abscess and anterior chest wall abscess, and Lahlou et al [10] reported Bezold abscess and sigmoid sinus thrombosis occurring concomitantly. The certain route of spread of infection to the paraspinal region leading to an abscess may be spread from Bezold abscess in the present case.…”

Bezold’s abscess: a rare complication of chronic suppurative otitis media in a 13 year old female child

“…However, some patients with otitis media develop serious complications due to delay in diagnosis, inadequate antibiotic therapy, increased bacterial resistance, negligence by the patients and concomitant presence of cholesteatoma. 1 The pus is prevented from reaching the surface by neck musculature but can track along the fascial planes of digastrics or sternomastoid muscle leading to various abscesses like Luc's abscess, Citelli's abscess, and Bezold abscess. 8 Well pneumatized mastoids are believed to be more susceptible to these complications than sclerotic mastoids because of increased capacity for the accumulation of pus and decreased capability of resorption.…”

“…Widespread use of antibiotics in the management of otitis media & mastoiditis has significantly decreased the complications of CSOM however, the rate of complication associated with squamous-type CSOM is still significant in Southeast Asia. 1,2 Bezold abscess which is named after Friedrich Bezold (German otologist, ) is defined as a complication of suppurative otitis media or acute mastoiditis when the disease passes inferiorly through the medial aspect of the mastoid tip into the sheath of the sternomastoid muscle as shown in Figure 1. 3 Bezold's abscess is an extratemporal complication accounting for 5.7 to 10.3% of all extracranial complications.…”