Clinical Practice and Cases in Emergency Medicine

Case Presentation: 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. 

Discussion: Bezold’s 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’s abscess in patients with otitis media.