Photoclinic

A 14-year-old girl presented to the emergency department with unilateral neck swelling, odynophagia, and dysphagia since last week. Her past medical history was significant for otitis media three weeks prior for which she had been treated successfully with amoxicillin. On physical examination, she had no distress with low grade fever. The tympanic membrane and pharynx were normal but on neck examination, there was a tender palpable mass along the anterior margin of the left sternocleidomastoid (SCM) muscle without erythema and without bruit on auscultation (Figure 1). Intravenous antibiotic therapy was started and computed tomography (CT) imaging of the neck with IV contrast was obtained. Neck Computed Tomography was taken.