R. NICKBRYANMDS. JAMESZINREICHMD
A 9-YEAR-OLD BOY was hospitalized with a 7-day history of high fever, gradually developing torticollis, a persistent headache, and pain in the right side of his neck. His medical history was noncontributory. The physical examination revealed right-sided torticollis and bilateral cervical lymphadenopathy, tending more to the right side. The results of the rest of the physical examination were normal. A contrast-enhanced computed tomographic (CT) scan of the head and neck region showed retropharyngeal soft tissue swelling with no ring enhancement. The patient was diagnosed as having deep neck infection. Intravenous injections of crystalline penicillin and metronidazole therapy were initiated, but the fever and the torticollis continued for 5 more days.
Gross M, Eliashar R, Attal P, Sichel J. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2001;127(12):1507. doi: