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Radiology Quiz Case 2
Mark A. Zacharek, MD;
Preeti N. Malani, MD;
Carol E. Chenoweth, MD
Wayne State University, Detroit, Mich (Dr Zacharek), and University
of Michigan Health System, Ann Arbor (Drs Malani and Chenoweth)
Arch Otolaryngol Head Neck Surg. 2002;128:597-599.
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A PREVIOUSLY HEALTHY 19-year-old man presented with an 8-day history
of fevers, sore throat, and pain in his left ear. Four days before he presented,
the results of a rapid streptococcal screen and a horse cell (Monospot) test
were negative. Despite symptomatic therapy for presumed viral pharyngitis,
his condition worsened; he developed progressive dyspnea and pleuritic chest
pain as well as diffuse joint aches.
On physical examination, the patient was lethargic, with a temperature
of 40°C, a pulse rate of 160 beats/min, a blood pressure reading of 115/44
mm Hg, and a respiratory rate of 36 breaths/min. Examination of his head and
neck revealed mild posterior pharyngeal erythema and anterior cervical lymphadenopathy.
There was no uvular deviation. Examination of his heart and lungs revealed
no abnormalities. No murmurs were audible. His left knee was tender, with
a moderate . . . [Full Text of this Article]
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