We report the case of a nine-year-old girl who presented to the health center with a left cervical tumor of two days duration, without fever.
As a history, there was a direct trauma in the same region one week before with the handle of a skateboard.
Examination revealed a soft, mobile tumor measuring 4 cm, with no adjacent inflammatory signs and pain upon palpation.
She was diagnosed with laterocervical adenitis and started treatment with oral amoxicillin-clavulanic acid.
After a week she is reviewed in consultation, persisting the pain and the tumor, this time indurated, without other accompanying symptoms, so she is referred to the Emergency Department of her reference hospital, where she visualizes an underlying antibiotic
Re-explorating the patient, it was decided to repeat the cervical ultrasound bilaterally.
The report indicates the presence of a thickening of the left MCS muscle with respect to the right, with alteration of echogenicity, visualizing two hypoechoic intramuscular foci compatible with an underlying abscess of 2.7 cm.
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The patient remains on intravenous treatment with cloxacillin and clindamycin for seven days, with progressive clinical improvement, and is discharged on treatment with oral clindamycin.
The patient is re-examined in consultation 15 days later, presenting to the examination the persistence of the left cervical tumor, although smaller.
A new bilateral cervical ultrasound was performed where no data suggestive of pyomyositis were observed, but the persistence of the abscess underlying the muscle, although with a significant reduction in its size.
The treatment was maintained for four weeks, with good evolution until complete resolution of the symptoms.
