Endgames
Spot Diagnosis
Neck swelling and enlarged tonsils
BMJ 2019; 366 doi: https://doi.org/10.1136/bmj.l4361 (Published 25 July 2019) Cite this as: BMJ 2019;366:l4361
- Charn Gill, ear, nose, and throat registrar,
- Max Sallis Osborne, ear, nose, and throat registrar,
- Lisha McClelland, ear, nose, and throat consultant
- Queen Elizabeth Hospital Birmingham, Birmingham, UK
- Correspondence to charn.gill{at}nhs.net
An 18 year old man presented with a seven day history of gradually worsening throat pain, malaise, vomiting, neck swelling, odynophagia, and pyrexia. He had no history of weight loss, foreign travel, or night sweats; no notable medical history; and he was not a smoker. Examination revealed bilateral tender swellings in the upper jugular node region that became more obvious on rotation of the neck. He spoke with …
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