Behind

Immune System


{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This young boy has presented with a high fever, severe dysphagia (as indicated by drooling of saliva), odynophagia, and restriction of neck movements. These symptoms are suggestive of a severe pathology of the throat.\n\nImportant diagnoses to consider include acute epiglottitis; a retropharyngeal, peritonsillar or parapharyngeal abscess; or a residual foreign body. In addition, cervical lymphadenopathy complicated by neck muscle spasms may present in this manner.\n\nExamination shows that no foreign bodies are present; that the epiglottis is normal; and that the tonsils are also normal.\n\nIn addition, note the bulging posterior pharyngeal wall - this is suggestive of a retropharyngeal abscess (RPA). This fits in with the history of impaction of a fish bone, as RPAs are well known to occur following penetrating trauma.\n\nNote that parapharyngeal abscesses typically cause a bulge in the lateral pharyngeal wall and lateralization of the tonsils - features which are absent in this child.\n\nA sof"}]}

Want to continue playing?

Open your Clinical Odyssey account today.


Enjoy unlimited access to 600+ simulations.
Safely improve your skills, anytime and anywhere.
Get answers to your follow-up questions from practicing physicians.