RT Journal Article
SR Electronic
T1 Adolescent with facial swelling
JF Archives of disease in childhood - Education & practice edition
JO Arch Dis Child Educ Pract Ed
FD BMJ Publishing Group Ltd and Royal College of Paediatrics and Child Health
SP 230
OP 232
DO 10.1136/archdischild-2019-317654
VO 106
IS 4
A1 Wen Shen Looi
A1 Si Hui Goh
A1 Colin Jingxian Tan
A1 Kheng Wei Yeoh
A1 Michaela Su-Fern Seng
YR 2021
UL http://ep.bmj.com/content/106/4/230.abstract
AB Background A previously well 15-year-old girl presented with a 2-month history of facial swelling that progressively worsened to involve the neck. There was associated dyspnoea, orthopnoea, headache and throat discomfort. Two weeks before presentation, the patient had an episode of fever for 5 days. On examination, vital signs were within normal limits. Swelling, plethora and venous distension of the face and neck were apparent (figure 1).Figure 1 (A) Patient before the onset of symptoms. (B) Patient at presentation.QuestionsWhat is the most likely diagnosis?Superior vena cava syndromeAngioedemaAnasarcaDiphtheriaDescribe the chest X-ray (figure 2).What are the acute concerns?What investigations would you order?Figure 2 Chest X-ray of the patient at presentation.Questions Answers can be found on page 02.