Bezold’s abscess and Lemierre’s syndrome after acute exacerbation of a chronic otitis media – A rare but severe complication.

Introduction Bezold’s abscess is a rare complication of an acute otitis media caused by pus drainage through the medial mastoid process wall and digastric groove. Expansion of purulent secretion can lead to infectious thrombophlebitis of the internal jugular vein.

If not diagnosed and treated on time, mediastinitis or spread of bacteria through the bloodstream with high mortality rate, respectively, might be the consequence.

Materials and Methods Here, we present a case of a 61-year-old male patient with simultaneously occurring Bezold’s abscess and Lemierre’s syndrome as a complication 2 weeks after the onset of an acute otitis media. We visualize the diagnosis with a contrast enhanced computed tomography scan of the neck and lateral skull base as well as intraoperative pictures.

Results Immediate surgical drainage, intravenous antibiotic therapy and therapeutic anticoagulation is essential. In this patient, three times of surgical intervention was necessary until definite cure because of recurring abscess formation.

Discussion Complicated courses of acute otitis media should be kept in mind and their appearance must be interpreted properly by otorhinolaryngologists in order to avoid severe consequences for the patient.

Publication History

Article published online:
24 May 2022