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February 1990

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Author Affiliations

University of Virginia School of Medicine, Charlottesville

Arch Otolaryngol Head Neck Surg. 1990;116(2):224-227. doi:10.1001/archotol.1990.01870020100027

PATHOLOGIC QUIZ CASE 1  Roseanne Boscia, MD, Robert D. Knox, MD, Charleston, SCAn 11-year-old girl presented with a 1-week history of fever and of a mass in the left side of her neck. In addition, she noted mild dysphagia, dysphonia, and trismus. Two weeks before the onset of these symptoms, she experienced a self-limiting sore throat and otalgia in her left ear. Her medical history was negative for tuberculosis exposure, but numerous cats were present in her home.On physical examination, two discreet tender fluctuant masses were present, one in the submandibular area, and the other, which was nearly 7 × 10 cm in diameter, anterior to the sternocleidomastoid muscle. A computed tomographic scan of the neck (Fig 1) demonstrated a large multiloculated abscess. The patient's white blood cell count was 18 × 109/L, with a normal differential cell count. Toxoplasma titers were negative. A purified protein

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