Pharyngitis with suppurative Cervical Lymphadenitis, CT
Claim CME CreditPOINT OF CARE INFORMATION
This CME activity consists of the student reviewing the video of the professor reviewing the case as well as the associated DICOM image set related to the case in question.
Learning Objectives
As a result of participation in this activity, participants should be able to:
- Provide improved patient care.
- Greater knowledge of the imaging characteristics of the patient's disease.
- Understand a better approach to interpretation of studies.
Faculty Disclosure
Mehmet Albayram, MD, Ivan Davis, MD, Mariam Hanna, MD, Anthony Mancuso, MD, Ronald Quisling, MD, Dhanashree Rajderkar, MD, Priya Sharma, MD, Roberta Slater, MD and Joann Stamm, MBA have disclosed that they have no relevant financial relationships. No one else is a position to control content have any financial relationship to disclose.
CME Advisory Committee Disclosure:
Conflict of interest information for the CME Advisory Committee members can be found on the following website: https://cme.ufl.edu/disclosure/.
Continuing Medical Education Credit
Accreditation: The University of Florida College of Medicine is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Credit: The University of Florida College of Medicine designates this enduring material for a maximum of 0.5 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity.
CA0153-Pharyngitis with suppurative Cervical Lymphadenitis, CT
View Images
CA0153-Pharyngitis with suppurative Cervical Lymphadenitis, CT
Case ReportHistory
Exam
Prior Study
Findings
General
There is general soft tissue swelling of the superficial and deep neck soft tissues on the right side. There is no evidence of gas in the soft tissues. There is no evidence of a foreign body separate from or in areas of soft tissue swelling.
Nasopharynx including retropharyngeal lymph nodes
The nasopharynx is normal and there is no evidence of significant changes within the parapharyngeal space for evidence of suppurative retropharyngeal adenopathy.
Oropharynx
There is excessive enhancement and thickening of the mucosa and swelling of the palatine and lingual tonsillar tissue and lymphoid tissue along the glossotonsillar sulci and posterior pharyngeal wall consistent with active pharyngitis. There is no tonsillar or pharyngeal abscess.
There is edema in the right parapharyngeal space and the retropharyngeal space with the parapharyngeal edema, extending to the right submandibular and masticator spaces.
Parotid and Submandibular Glands
There is swelling of the right parotid and submandibular glands and surrounding edema as reaction to the spreading cellulitis in the adjacent deep spaces described previously.
Hypopharynx, larynx, deep neck and entire retropharyngeal space
There is reactive cervical lymphadenopathy in level 2 and 3 on both sides and level 4 on the right.
In level 2 on the right, there is a suppurative cervical lymph node which is 3 cm in maximum short axis diameter without definite evidence of extranodal spread of purulent material but with related cellulitis in the adjacent carotid sheath and sternocleidomastoid muscle as well as more superficial soft tissues.
Vascular findings
There is no evidence of thrombus, thrombophlebitis or other occlusive or inflammatory process of the jugular vein or smaller venous tributaries. However, the right internal jugular vein is compressed.
There is no evidence of thrombus, inflammation of the common, external or internal carotid artery. There is no evidence of active extravasation or a contained leakage from an arterial source.
Impression
There is no current significant airway compromise or venous thrombosis.
