Mehl. UW bullet cases 4 pharyngeal abscess

Question 1

UW. 4-year-old boy + fever and neck pain. He has had rhinorrhea, nasal congestion, and a sore throat for the past week. Two days ago, he developed fever and worsening neck pain. Today, the patient has refused to eat or drink. He has no chronic medical conditions, and immunizations are current. Temp. 39.7 C, pulse 120/min, RR 24/min. Patient appears tired and uncomfortable. Palpation of the neck reveals bilateral anterior cervical lymphadenopathy. The patient refuses to move his neck; passive extension is painful. His voice is muffled. Mouth opening is limited by pain, and the tonsils appear erythematous and symmetrically enlarged with white exudates. The uvula is midline. Chest auscultation reveals good bilateral air entry without stridor or rhonchi. Lateral neck radiograph is shown in the exhibit. Dx?

Answer 1

RETROPHARYNGEAL ABSCESS

buvo xray vaizdas - retropharyngeal abscess

Question 2

UW. 4y/o boy + 1-day fever of 38.4 C and left-sided neck swelling. Red, tender, and fluctuant mass approximately 2 cm in diameter in the left anterior cervical lymph node chain.
Vaccinations are up to date. Dentition and oropharynx are normal. There are no other areas of lymphadenopathy. Which of the following is the most likely infectious etiology?

Answer 2

STAPH. AUREUS

This child has acute, unilateral cervical lymphadenitis, which is most commonly caused by Staphylococcus aureus or Streptococcus pyogenes