A woman with trismus and fever

A 65-year-old woman presented with one week duration of fevers to 38 °C, 3 days of anterior neck pain, sore throat, and trismus. Physical examination showed tender masseter muscles bilaterally, with an inability to open her mouth past 1.5 finger breadths. (Figure 1A) Both temporal and carotid arteries were tender to palpation. Laboratory data showed an elevated C-re active protein level of 18.2 mg per deciliter, an erythrocyte sedimentation rate level of 110 mm per hour, and alanine and aspartate aminotransferase levels of 63 and 74 U/L per liter respectively.
Source: The American Journal of Medicine - Category: General Medicine Authors: Tags: Clinical Communication to the Editor Source Type: research