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...

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