Presentation
Three weeks of sore throat with three days left neck pain. New swelling and erythema. Systemically unwell. Tender left levels 2/3, erythema spreading to anterior chest wall.
Patient Data
Multiple lymph nodes are enlarged bilaterally. This is worse on the left, with confluent and necrotic nodes in levels 2B and 5. Marked overlying inflammatory fat stranding and superficial edema extending from the skull base to the supraclavicular fossa.
No upper aerodigestive tract mass. No peritonsillar abscess. Normal major vessels (no thrombus). Normal included chest.
Case Discussion
With this clinical history, this inflammatory appearance with necrotic nodes and extensive perinodal reticulation, was managed as cellulitis with reactive lymphadenitis. Good clinical improvement.
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