Modern Presentations of Bezold's Abscess

The use of antibiotics in suppurative otitis media has greatly diminished the incidence of complications. Deep neck abscess arising from acute mastoiditis, a disease thoroughly described by Frederick Bezold early in this century, has become rare. In the last three years we have treated five cases of deep neck abscess of otogenic origin at our hospital. These cases exemplify Bezold's classic description in their site of origin in the mastoid process and route of spread in the neck. However, our contemporary examples differed in clinical setting, latency of onset, and bacterial cause. In four of the cases, delay in diagnosis occurred because of failure to recognize the disorder. Computed tomography has proved valuable in the anatomic diagnosis and surgical planning. Renewed familiarity with the clinical presentations and pathogenesis of this now uncommon condition may prevent delay in diagnosis and initiation of therapy.