A Pain In The Neck

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A Pain In The Neck - Page #3

Lab Studies: CBC was notable for new WBC of 24,500. CMP showed a stable transaminitis and troponins were down-trending from recent admission. EKG showed sinus tachycardia. TTE showed no vegetations. He tested negative for COVID and flu, and had previously tested negative for group A strep and mononucleosis during his previous hospitalization. Chest x-ray demonstrated cardiomegaly with mild interstitial edema and small bilateral pleural effusions. Other Studies: CT angiogram of the chest showed findings concerning for multifocal septic emboli. Admitting team requested a CT angiogram of the neck which demonstrated a left internal jugular vein filling defect extending from the level of C1 to C6. Normal right side (for comparison): Case Photo #1 Left side (affected side): Case Photo #2 Consultations: Infectious disease and vascular surgery were consulted to aid with treatment recommendations. Click here to continue. Challenge yourself by writing down a revised, working diagnosis before moving to the next slide.		Back
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