Malignant otitis external complicated by bezold abscess: one case report

Résumé

Introduction: Bezold abscess is defined as a rare deep abscess, a complication of acute mastoiditis secondary to chronic otitis media. Factors favoring the spread of this cervical abscess are the virulence of the germ, delayed management of otitis media and associated immunosuppression. Bezold abscesses are treated medico-surgically.

Case report: 57-year-old patient, type 2 diabetic on oral antidiabetics. Admitted for management of malignant otitis external complicated by otomastoiditis with bezold abscess. Cervical examination reveals a retroauricular collection extending to the cervical region. The patient underwent medical and surgical treatment consisting of antibiotic therapy with drainage of the cervical abscess. The course was marked by persistent infection with extension to the dorsal region associated with pulmonary effusion. The patient was readmitted to the operating room, having undergone drainage with a dorsal staged incision, combined with mastoidectomy and tympanoplasty using an open technique. Drainage of the pulmonary effusion was performed locally in the patient's bed.

Conclusion: Bezold's abscess is a rare complication of acute otitis media. It is a therapeutic emergency, with medical and surgical treatment. Appropriate and prompt management of chronic otitis media can prevent the onset of formidable complications.