Presentation
16 year old female presented to the emergency with left jaw and neck swelling and trismus. Immediate history of tonsillitis for past 4 days, initially managed with oral antibiotics.
Patient Data
Note: This case has been tagged as "legacy" as it no longer meets image preparation and/or other case publication guidelines.
Upper airway compromise with gross tonsil and uvula swelling subsequently requiring intubation.
Peritonsillar and neck cellulitis: Fluid (marked by arrows) in the peritonsillar space extending superiorly into the parapharyngeal space and medially into the pre-epiglottic space. Swelling of the left parotid gland (marked by asterisks), masticatory muscles, and other soft tissues of the neck.
Jugular thrombophlebitis: Occlusive thrombus in the left external jugular vein (marked by carets) extending into the retromandibular vein with enhancement at the margins of the vein.
Lymphadenopathy: Enlarged cervical lymph nodes.
Systemic sepsis: Raised white cell count, CRP >200, tachycardia, hypotension and respiratory acidosis.
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