Bezold’s abscess in a diabetic patient without significant clinical symptoms

A 52-year-old Japanese man with a history of type 2 diabetes mellitus (DM) presented with mild dizziness. On admission, the physical examination only revealed tachycardia and right sided cervical lymphadenopathy. On the fifth day of admission, his mental status slightly worsened. Urgent Computed Tomography (CT) of the head and neck revealed multiple abscesses spreading from the right temporal bone to the right sternocleidomastoid muscle. Bezold’s abscess was diagnosed. Streptococcus pneumoniae was isolated from middle ear fluid and blood cultures. Bezold’s abscess has rarely been described in the era of antimicrobial therapy. However this abscess can still occur in patients without any typical severe symptoms. Repeated history taking and thorough physical examination can help detect Bezold’s abscess.