A 10-year-old boy presents with toicollis, a tender swelling behind the angle of mandible and fever. He had history of ear discharge for the past 6 years. Examination of the ear showed purulent discharge and granulations in the ear canal. Most probable diagnosis is:
Bezold abscess Purulent discharge, granulations in the ear canal, tender swelling between the angle of mandible and mastoid indicates Bezold abscess. Toicollis is due to spasm of sternocleidomastoid muscle. In Bezold abscess, pus bursts through the medial side of tip of mastoid. There is no ear discharge or granulations in masked mastoiditis. In parotitis there is associated swelling over the parotid area.
Acute lymphadenitis secondary to otitis externa
Masked mastoiditis
Bezold abscess
Parotitis