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November 1971

The Resident's Page

Author Affiliations

1721 Pine St, Philadelphia 19103; The Methodist Hospital, Houston 77025

Arch Otolaryngol. 1971;94(5):476-479. doi:10.1001/archotol.1971.00770070722018

PATHOLOGIC QUIZ CASE 1  Hector J. Seda, MD, Reading, PaA 3-year-old child was seen for a mass in the neck which had been present for several months. There was no history of pharyngitis, exposure to pets, or injection of unpasteurized milk. Results of the otolaryngic examination at this time were completely normal except for the presence of an erythematous 4-cm mass anterior to the left sternocleidomastoid. The white blood cell count was 7,800/cu mm with a normal differential. An x-ray film of the chest was normal and tine and fungal skin tests were negative. A nasopharyngeal and throat culture and sensitivity test was done and a regimen of antibiotics was prescribed for what appeared to be an infected branchial cleft cyst. While the patient was receiving antibiotics, a cutaneous fistula draining serous fluid developed. Cultures for bacteria, fungi, and acid-fast bacilli were performed and gram and Ziehl-Neilsen stains were

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