A previously healthy 15-year-old female adolescent is admitted to the hospital with fever, neck swelling, and failure to improve while taking multiple antibiotic agents. One month ago she noticed a lump behind her left ear; it resolved spontaneously but recurred approximately 3 weeks later along with tenderness and fevers. Around this time she had a raised, scabbed lesion on her left scalp, which her sister lanced. Her pediatrician started the patient on amoxicillin/clavulanic acid. Five days later she presented to the emergency department with persistent fevers. A complete blood cell count was normal and a neck computed tomographic (CT) scan showed diffuse subcutaneous edema consistent with cellulitis, so she was started on cephalexin and trimethoprim/sulfamethoxazole and was discharged. However, her symptoms worsened, with continued fevers, vomiting, pharyngitis, and swelling of the area behind her left ear. She returned to the emergency department 3 days later and was admitted to the...
Case 2: Scalp Lesion and Neck Swelling in a Female Adolescent
Drs Lammert, Dell, and Saidi have disclosed no financial relationships relevant to this article. This commentary does not contain a discussion of an unapproved/investigative use of a commercial product/device.
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Karin Lammert, Adam Dell, Merium Saidi; Case 2: Scalp Lesion and Neck Swelling in a Female Adolescent. Pediatr Rev July 2020; 41 (7): 361–364. https://doi.org/10.1542/pir.2018-0012
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