Citelli’s Abscess Following Otitis Media, A Case Report

Document Type: Case Report


Department of ENT and Head and Neck Surgery, All India Institute of Medical Science, Bhubaneswar, Odisha, India.


Citelli’s abscess is an extratemporal complication of otitis media. It occurs when pus from the mastoid tip trickles down along the posterior belly of the digastric muscle to the occipital and cervical region. It is a very unusual presenting complication of chronic otitis media with no available data in the until now.
Case Report:
A 10-year-old female was presented to our outpatient department with a 1 month history of hi-grade fever and headache and pain around the left half of the face. During physical examination a huge swelling present in the left temporal and occipital region was observed. The swelling crossed the midline, was tender to touch, and was fluctuant. During otological examination left sided chronic suppurative otitis media, of the attico-antral type with cholesteatoma, and a profuse foul smelling purulent discharge was observed. After complete investigation, drainage of the patient’s abscess was performed under general anesthesia. A postaural incision was administered and around 500 ml of pus drained out. Immediately after the operation, the patient showed signs of recovery. After 3 weeks of parenteral antibiotic therapy, the primary focus was debrided by performing left modified radical mastoidectomy.
Citelli's abscess is a rare complication of otitis media. Urgent radiology, followed by drainage of pus is performed to reduce pain and further progression of the infective process. The primary ear pathology is managed surgically after adequate treatment with intra venous antibiotics.


Main Subjects

1. Lin YS, Lin LC, Lee FP, Lee KJ. The prevalence of chronic otitis media and its complication rates in teenagers and adult patients. Otolaryngol Head Neck Surg. 2009;140(2):165–70.

2. Yorgancilar E, Yildirim M, Gun R, Bakir S, Tekin R, Gocmez C, et al. Complications of chronic suppurative otitis media: a retrospective review. EurArch Otorhinolaryngol 2013; 270(1):69–76.

3. Spiegel JH, Lustig LR, Lee KC, Murr AH, Schindler RA. Contemporary presentation and management of a spectrum of mastoid abscesses. Laryngoscope. 1998; 1994(108):779–82.

4. Pradhananga R. An Unusual Complication of Chronic Suppurative Otitis Media: Bezold Abscess Progressing to Scapular Abscess. Int Arch Otorhinolaryngol. 2014; 18(4): 412–4.