A 27-year-old hispanic man presented to the emergency department with acute bilateral neck swelling that had occurred after a severe bout of coughing. His medical history was significant for long-term use of methamphetamine, marijuana, and tobacco. Two weeks before admission, he had noted a new-onset, nonproductive cough. On the morning of admission, he had a rather forceful episode of coughing that was subsequently accompanied by bilateral neck swelling, described as “small balloons under the skin.” He denied change in voice, dyspnea, sore throat, odynophagia, dysphagia, hemoptysis, palpitations, and chest pain.
Cohen M, Wang MB, Nguyen CT. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2007;133(6):615. doi:10.1001/archotol.133.6.615