Rare Case of Bezold Abscess Left Post Auricular Region

Abstract

 Background: Bezold's Abscess is a rare but serious complication of Chronic Otitis Media

(COM) that occurs when purulent material from mastoiditis extends into the sternocleidomastoid and digastric muscles. Although the advent of antibiotics has reduced its incidence, delayed diagnosis can result in life-threatening complications such as lateral sinus thrombosis and intracranial infections. Early recognition and intervention are crucial to prevent irreversible damage. Case Presentation: We report the case of a 10-year-old male who presented with post-auricular swelling and purulent discharge from the left ear. Clinical examination identified a fluctuant, non-tender abscess, and High-Resolution CT (HRCT) imaging revealed mastoiditis, loss of mastoid pneumatization, coalescence, and bony cortical erosion. Culture and sensitivity testing confirmed Pseudomonas aeruginosa as the causative organism. Initial management included immediate abscess drainage, intravenous antibiotics, and supportive therapy. A Canal Wall down Mastoidectomy was performed to eradicate the infection and prevent complications. Pure Tone Audiometry (PTA) demonstrated mild conductive hearing loss pre-operatively, with a 5dB improvement postsurgery. Follow-up evaluations at 1, 2, 3, and 6 weeks indicated satisfactory recovery with no recurrence or further complications. Conclusion: This case illustrates the critical importance of early diagnosis, comprehensive imaging, and timely surgical intervention in managing Bezold's Abscess secondary to Chronic Otitis Media. Prompt medical and surgical management not only prevented life-threatening complications but also preserved auditory function, highlighting the effectiveness of a multidisciplinary approach in otogenic infections.