Tsuruta Satoshi, Fujiwara Takashi
Kurashiki Central Hospital, Department of Otolaryngology, Kurashiki city, Okayama, Japan.
Clin Pract Cases Emerg Med. 2024 Aug;8(3):295-297. doi: 10.5811/cpcem.21313.
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.
一名57岁男性,有支气管哮喘和嗜酸性鼻窦炎病史,因中耳炎加重就诊于急诊科。他的主要症状是耳漏、头痛和颈部疼痛伴发红。增强计算机断层扫描显示后颈部脓肿与乳突相连。患者接受了乳突切除术并接受了抗菌治疗。中耳的嗜酸性肉芽组织阻塞了中耳入口,并将炎症过程引向乳突尖。
贝佐尔德脓肿是急性乳突炎罕见的颅外并发症。因此,临床医生应将颈部疼痛伴发红视为中耳炎患者提示贝佐尔德脓肿的重要体征。