A 68-YEAR-OLD man with coronary artery disease presented with right-sided facial swelling and erythema. His symptoms began after a fractured right upper molar was capped. He was admitted with a presumptive diagnosis of facial cellulitis, which failed to improve with a regimen of oral antibiotics. When the antibiotic therapy was discontinued, the patient became febrile. He also developed diffuse erythema and induration of the oropharynx, with focal ulceration of the left palatine tonsil and uvula. Biopsy specimens and fluid smears obtained from the right nares were nondiagnostic.
Samir S. Khariwala, David A. Litman, Shelly J. McQuone, Jay L. Hess, Erica R. Thaler. Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2000;126(11):1390–1393. doi: