PMC6488560_01
CT of the temporal bone (left image) showing complete opacification of right mastoid air cells and middle ear cavity with surrounding sclerosis of the mastoid bone (arrow). CT soft tissue of the neck (right image) showing erosion of the cortex of the mastoid tip with adjacent abscess compatible with Bezold's abscess and extension to retropharyngeal space (arrow).
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Computed tomography (CT) of the right ear and neck showed right sided chronic mastoiditis, erosion of the inferior mastoid cells, extension of the infection into the neck spaces and formation of a Bezold's abscess in the ipsilateral sternocleidomastoid muscle, extending into the retropharyngeal space (Fig. 1).
Gallium scan initial (upper row) increased uptake right mastoid and skull base (arrows). Increase uptake in left parotid is a normal. Repeat studies (second row) following resolution of infection show no focal uptake.
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MRI of the brain, triple phase bone scan and a Gallium scan (Fig. 2) and SPECT CT scan (Fig. 3) revealed extensive involvement of the infection to the petrous portion of the temporal bone, a retropharyngeal collection, intracranial dural enhancement and skull base. The patient had serial ESR, CRP and Gallium scans (Fig. 2) and CT SPECT scans (Fig. 3).