Luc's Abscess and Temporomandibular Joint Septic Arthritis: Two Rare Sequelae of Acute Otitis Media

A 5-year-old previously healthy child presented with right-sided otalgia, right facial and temporal swelling, and right jaw pain in the setting of 6 days of low-grade fever. The child had no trauma, vomiting, or prior dental treatments. On physical examination, the patient had facial swelling, erythema, and tenderness over the right temporal region along with trismus, as well as pain on palpation of the right temporomandibular joint (TMJ). A computed tomography scan revealed otitis media, Luc's abscess, and TMJ septic arthritis requiring surgical drainage and intravenous antibiotics. The patient responded well to treatment and recovered without sequelae. Dr. Cardwell Luc first described Luc's abscess in 1913 as a rare complication of middle ear infection leading to an abscess in the infratemporal space. To our knowledge, our case is the first documented case of concurrent Luc's abscess and TMJ septic arthritis in a previously healthy child as complications of acute otitis media. This case highlights 2 rare complications of a common medical condition that pediatric emergency care providers should recognize due to the need for surgical intervention, without which there may be longstanding sequelae.