Atypical presentation of Bezold's and Citelli's abscesses, with recollection following an incomplete postoperative course of antibiotics

BMJ Case Rep. 2017 Jan 17:2017:bcr2016218072. doi: 10.1136/bcr-2016-218072.

Abstract

Bezold's and Citelli's abscesses are rare complications of otitis media. We present a case of a 44-year-old Eastern European man, with a history of recurrent otitis media, who was admitted to hospital with mastoiditis and initially treated with antibiotics. Despite clinical improvement, a CT scan showed mastoiditis with Bezold's and Citelli's abscesses. The patient underwent a myringotomy and grommet insertion, in addition to a cortical mastoidectomy and curettage of the neck abscesses. After a good recovery, he was discharged home. However, likely due to the language barrier, he did not complete a course of antibiotics as prescribed, and the abscess re-collected, necessitating a re-admission and re-operation. This report illustrates the importance of considering rare features of a common disease in the differential, and of communication in ensuring compliance.

Publication types

  • Case Reports

MeSH terms

  • Abscess / diagnostic imaging
  • Abscess / therapy*
  • Adult
  • Anti-Bacterial Agents / therapeutic use*
  • Humans
  • Male
  • Mastoid / diagnostic imaging
  • Mastoid / surgery*
  • Mastoiditis / diagnostic imaging
  • Mastoiditis / therapy*
  • Medication Adherence*
  • Otitis Media / therapy*
  • Otorhinolaryngologic Surgical Procedures*
  • Postoperative Care
  • Recurrence
  • Tomography, X-Ray Computed

Substances

  • Anti-Bacterial Agents