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Special Feature
May 1999

Picture of the Month

Author Affiliations

From the Department of Pediatrics, Section of Infectious Diseases, Scott & White Clinic and Memorial Hospital, Texas A&M University Health Science Center, Temple, Tex.




Copyright 1999 American Medical Association. All Rights Reserved. Applicable FARS/DFARS Restrictions Apply to Government Use.1999

Arch Pediatr Adolesc Med. 1999;153(5):543. doi:

A 7-YEAR-OLD girl from central Texas had a persistent, slowly growing mass in her right cheek for 3 months. There was no history of fever, and trauma or insect bite at the site was denied. The family had a cat and the girl enjoyed fishing. At her initial presentation 2 months previously, she was treated with 10 days of cephalexin and the mass was injected with a corticosteroid. The mass initially seemed to get smaller but then grew.

On physical examination, the mass, which measured 20 × 13 mm, was visible on the right cheek and palpable in the right upper buccal sulcus (Figure 1 and Figure 2). It was slightly tender and appeared to have a soft center. There was no regional lymphadenopathy. Findings from the rest of the physical examination were normal. An aspiration of the mass was performed and cultures were obtained for aerobic and anaerobic bacteria, acid-fast bacilli, and fungi.