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Case Reports
. 2021 Oct 14;385(16):1511-1520.
doi: 10.1056/NEJMcpc2027096.

Case 31-2021: A 21-Year-Old Man with Sore Throat, Epistaxis, and Oropharyngeal Petechiae

Hanno Hock  1 , Hillary R Kelly  1 , Eric A Meyerowitz  1 , Matthew J Frigault  1 , Lucas R Massoth  1
Affiliations
Case Reports

Case 31-2021: A 21-Year-Old Man with Sore Throat, Epistaxis, and Oropharyngeal Petechiae

Hanno Hock et al. N Engl J Med. .
No abstract available

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Figures

Figure 1
Figure 1. Clinical Photograph.
A photograph obtained on the day of admission shows a palatal petechia.
Figure 2
Figure 2. Peripheral-Blood and Bone Marrow Specimens.
Wright–Giemsa staining of a peripheral-blood smear (Panel A) shows a circulating plasmacytoid lymphocyte; platelets are notably absent, a finding consistent with thrombocytopenia. Hematoxylin and eosin staining of bone marrow (Panel B) shows markedly hypocellular marrow. At higher magnification (Panel C), the residual cellularity is composed mainly of lymphocytes (arrowhead) and plasma cells (arrow). In situ hybridization of bone marrow to detect severe acute respiratory syndrome coronavirus 2 (Panel D) is negative, without the red chromogen staining that indicates the presence of viral RNA; the inset shows an example of positive cellular staining in human lung tissue.
Figure 3
Figure 3. CT Scan of the Neck.
CT of the neck was performed after the administration of intravenous contrast material in a soft-tissue algorithm. An axial image (Panel A) shows hypoattenuating peritonsillar phlegmon (circled), which is causing partial effacement of the oropharyngeal airway. A coronal image (Panel B) shows the rim of the hypoattenuating phlegmon in the peritonsillar space (arrow) adjacent to the enlarged right palatine tonsil (asterisk). There is no evidence of a well-defined rim-enhancing abscess.
See this image and copyright information in PMC

References

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