R. NICKBRYANMDS. JAMESZINREICHMD
A 38-YEAR-OLD white man presented to the emergency department with a 3-day history of progressive odonyphagia. He reported that the pain had initially been localized to the left submandibular region but had generalized to the central area of his neck over the prior 48 hours. He was seen by his primary care physician during the first day of his illness, and he was given cephalexin (Keflex) and narcotic pain medicine for a presumed diagnosis of sialadenitis. He was again seen in a local emergency department on the second day of his illness. He was told that his examination results were "normal" and instructed to continue his antibiotic regimen. He again reported to the emergency department room on the third day of his illness and reported that his odonyphagia had progressed to the point that he was unable to take solid or liquid nutrition for 12 hours and to tolerate his own secretions for 6 hours. He denied dyspnea, shortness of breath, fever, or other symptoms of recent upper respiratory tract infection. His surgical and medical histories were unremarkable; he had no known drug allergies; and he was taking no other medications.
Cable BB, Biega T. Quiz Case 1. Arch Otolaryngol Head Neck Surg. 2001;127(2):212. doi:10.1001/archotol.127.2.212