Case 8

1. Presented by Cherub Kim, MD and reviewed by Patricia Simner, MSc, PhD

Clinical Vignette

A previously healthy young adult presents to the emergency department with a sore throat which started two weeks ago. The patient has been taking amoxicillin prescribed by an urgent care clinic. However, despite treatment, the patient's symptoms have worsened and now include hoarseness, dysphagia, and right neck pain. On exam, the patient has a fever and is mildly tachycardic. A complete blood count shows an elevated white blood cell count of 16.7 K/cu mm (reference range, 4.5 - 13.0 K/cu mm). The patient's right neck is tender and swollen, with a prominent external jugular vein. The right tonsil is swollen. A computed tomography (CT) scan of the head (Figure 1) shows a 2.1 cm right peritonsillar abscess. Doppler ultrasonography shows thrombosis of the right external jugular vein. The abscess is drained and sent for gram stain and culture. The gram stain is shown in Figure 2.




Which is the most likely causative organism?


 

298 thoughts on “Case 8”

  1. Wow that was unusual. I just wrote an very long comment but after I clicked submit my comment didn’t show up. Grrrr… well I’m not writing all that over again. Regardless, just wanted to say great blog!

  2. Thanks for your blog post. The things i would like to bring up is that computer system memory should be purchased should your computer cannot cope with what you do with it. One can add two RAM boards of 1GB each, for instance, but not certainly one of 1GB and one with 2GB. One should look for the manufacturer’s documentation for the PC to make certain what type of ram is required.

  3. Hey there! Quick question that’s entirely off topic. Do you know how to make your site mobile friendly? My blog looks weird when browsing from my iphone. I’m trying to find a template or plugin that might be able to correct this issue. If you have any recommendations, please share. Thank you!

  4. I’ve been surfing on-line more than 3 hours lately, but I never found any fascinating article like yours. It is beautiful worth sufficient for me. In my opinion, if all site owners and bloggers made excellent content material as you did, the internet will likely be a lot more helpful than ever before.

  5. I’ve been surfing on-line greater than 3 hours today, but I never discovered any fascinating article like yours. It抯 pretty worth enough for me. In my view, if all web owners and bloggers made good content as you probably did, the web will probably be a lot more helpful than ever before.

  6. Excellent post but I was wondering if you could write a litte more on this topic? I’d be very grateful if you could elaborate a little bit more. Cheers!

  7. One thing I’d really like to touch upon is that fat reduction plan fast is possible by the correct diet and exercise. Ones size not just affects the look, but also the overall quality of life. Self-esteem, depression, health risks, and physical capabilities are impacted in fat gain. It is possible to make everything right and still gain. If this happens, a condition may be the perpetrator. While a lot of food instead of enough exercising are usually guilty, common health concerns and key prescriptions can greatly amplify size. Thx for your post here.

  8. Good web site! I truly love how it is easy on my eyes and the data are well written. I am wondering how I could be notified whenever a new post has been made. I’ve subscribed to your RSS which must do the trick! Have a nice day!

  9. Great beat ! I would like to apprentice while you amend your web site, how could i subscribe for a blog site? The account helped me a acceptable deal. I had been a little bit acquainted of this your broadcast provided bright clear concept

  10. Good web site! I truly love how it is easy on my eyes and the data are well written. I am wondering how I could be notified whenever a new post has been made. I’ve subscribed to your RSS which must do the trick! Have a nice day!

  11. Thanks for posting. I really enjoyed reading it, especially because it addressed my problem. It helped me a lot and I hope it will help others too.

  12. I’m really loving the theme/design of your web site.
    Do you ever run into any web browser compatibility problems?
    A number of my blog visitors have complained about my
    site not working correctly in Explorer but looks great in Opera.
    Do you have any solutions to help fix this problem?

  13. Wow that was strange. I just wrote an incredibly long comment
    but after I clicked submit my comment didn’t show up.
    Grrrr… well I’m not writing all that over again. Anyways, just wanted to say wonderful blog!

Leave a Reply

Your email address will not be published. Required fields are marked *