# Bezold Abscess in a Case of Eosinophilic Otitis Media

## TL;DR

A rare Bezold abscess was diagnosed in a patient with otitis media, highlighting the importance of recognizing neck pain and redness as potential signs.

## Contribution

This case report emphasizes the clinical significance of neck symptoms in diagnosing Bezold abscess in otitis media.

## Key findings

- Contrast-enhanced CT identified a posterior neck abscess connected to the mastoid process.
- Eosinophilic granulation tissue obstructed the middle ear aditus, directing inflammation toward the mastoid tip.
- Mastoidectomy and antimicrobial therapy were effective treatments for the Bezold abscess.

## Abstract

A 57-year-old man with a history of bronchial asthma and eosinophilic sinusitis presented to the emergency department with an exacerbation of otitis media. His primary complaints were otopyorrhea, headache, and neck pain with redness. Contrast-enhanced computed tomography revealed a posterior neck abscess contiguous with the mastoid process. The patient underwent mastoidectomy and received antimicrobial therapy. Eosinophilic granulation tissue in the middle ear obstructed the middle ear aditus and directed the inflammatory process toward the mastoid tip.

Bezold abscess is a rare extracranial complication of acute mastoiditis. Therefore, clinicians should consider neck pain with redness as an important physical sign that suggests Bezold abscess in patients with otitis media.