Bezold Abscess: Causes and Treatment

Written by Medicover Team and Medically Reviewed by Dr Neha A Padia , ENT

Causes
Find a Doctor
Diagnosis
Treatment
FAQs
Book an Appointment

1. Causes 2. Find a Doctor 3. Diagnosis 4. Treatment 5. FAQs

In the realm of otolaryngology, Bezold abscess presents as a rare but significant complication associated with untreated or inadequately treated mastoiditis. First identified by Friedrich Bezold in 1881, this condition underscores the critical importance of timely intervention in infections of the mastoid bone.

We provide a comprehensive overview of Bezold abscess, encompassing its causes, symptoms, diagnosis, treatment, and potential complications.

What is a Bezold Abscess?

Bezold abscess is a deep neck abscess that occurs when pus from an infected mastoid air cell invades the soft tissues of the neck. The condition typically arises following the erosion of the mastoid tip, allowing the purulent material to track into the sternocleidomastoid muscle sheath and beyond. This unusual mode of infection is what characterizes the abscess, setting it apart from other complications of mastoiditis.

What Are the Causes of Bezold Abscess?

Origin of Mastoiditis

The primary precursor to Bezold abscess is mastoiditis, an infection of the mastoid process of the temporal bone. The mastoid bone, located behind the ear, contains air cells that can become inflamed and infected, usually as a complication of acute otitis media (middle ear infection). When the infection is not adequately managed, it can lead to the formation of a Bezold abscess.

Pathophysiology

The pathophysiological mechanism involves the erosion of the thin cortical bone of the mastoid, which permits the infection to extend beyond its usual confines. This breach allows infectious material to spread into the surrounding neck tissues, particularly beneath the sternocleidomastoid muscle, leading to abscess formation.

What Are the Symptoms of Bezold Abscess?

The clinical presentation of Bezold abscess can be varied, but several symptoms are commonly observed:

Neck Swelling: A notable swelling in the upper neck is often present, often tender and warm to the touch.
Pain: Persistent neck and ear pain is a frequent complaint.
Fever: Patients often exhibit febrile episodes due to the underlying infection.
Reduced Neck Mobility: An abscess may restrict neck movements.
Hearing Loss: Conductive hearing loss may result from middle ear pathology.

When to See a Doctor for Bezold Abscess?

A Bezold abscess requires immediate evaluation by an otolaryngologist (ENT specialist) or your primary care physician. This deep neck infection is a serious complication of mastoiditis that demands prompt medical attention to prevent life-threatening consequences.

You should see a doctor if you have:

Persistent ear pain with swelling or tenderness below the ear or along the neck
Fever with drainage from the ear, difficulty swallowing, or stiff neck
A recent ear infection that hasn't improved with treatment

Get medical help immediately if:

High fever (above 103°F/39.4°C) with severe neck pain or visible neck swelling
Difficulty breathing, speaking, or swallowing with a rapid heartbeat
Confusion, severe headache, or signs of sepsis, such as extreme weakness

These could be signs of a serious complication, such as meningitis, which requires urgent care.

Find Ent for Bezold Abscess Treatment Near You

How is Bezold Abscess Diagnosed?

Clinical Examination

The initial diagnosis often begins with a detailed clinical examination, focusing on the history of mastoiditis or persistent ear infections and on the presence of neck swelling and pain.

Imaging Studies

CT Scan: A computed tomography (CT) scan of the temporal bone and neck is crucial for confirming the diagnosis. It helps visualize the extent of the abscess and any erosion of the mastoid process.
MRI: Magnetic resonance imaging (MRI) can provide additional detail regarding the involvement of soft tissues and the spread of infection.

Laboratory Tests

Blood tests may reveal leukocytosis and elevated inflammatory markers, supporting the diagnosis of an ongoing infection.

What Are the Treatment Options for Bezold Abscess?

The management of Bezold abscess requires a multidisciplinary approach involving otolaryngologists and, at times, infectious disease specialists.

Medical Management

Antibiotics: Broad-spectrum intravenous antibiotics are the cornerstone of initial management. The antibiotic regimen is often adjusted based on culture results from aspirated pus.

Surgical Intervention

Mastoidectomy: A mastoidectomy is often performed to remove the infected mastoid air cells and prevent further spread of infection. This procedure involves the surgical excision of the mastoid bone and drainage of the abscess.
Neck Exploration and Drainage: In cases where the abscess has significantly extended into the neck, surgical drainage may be necessary to remove the purulent collection and alleviate symptoms.

Postoperative Care

Post-surgical care includes continued antibiotic therapy and regular follow-up to monitor infection resolution and prevent recurrence.

Your health is everything - prioritize your well-being today.

Consult Bezold Abscess Doctors Today

What Are the Complications of Bezold Abscess?

If not treated promptly, a Bezold abscess can lead to several serious complications:

Deep Neck Space Infections: The abscess may extend into other deep neck spaces, causing further complications.
Thrombophlebitis: Inflammation of the veins in the neck can occur, leading to potentially life-threatening conditions such as Lemierre's syndrome.
Facial Nerve Palsy: The infection can affect the facial nerve, leading to paralysis.
Intracranial Extension: Rarely, the infection may spread intracranially, leading to meningitisor a brain abscess.

What Are the Preventive Strategies

Preventing Bezold abscess primarily involves the timely and effective treatment of acute otitis media and mastoiditis. Ensuring complete resolution of these infections with appropriate antibiotics and, if necessary, surgical intervention is key.