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A 60-year-old woman with a history of metastatic neuroendocrine tumor presented with rapidly progressive swelling of the left side of the face. She was dehydrated and acutely ill, with a temperature of 36.1°C, a pulse of 106 per minute, and a blood pressure of 106/58 mm Hg. The left preauricular area of her face was markedly swollen, and a firm, tender mass was palpable. Pus was expressed from the parotid (Stensen's) duct. The white-cell count was 54,400 per cubic millimeter, with 41 percent segmented granulocytes and 20 percent band forms. A computed tomographic scan of the head with the intravenous . . . [Full Text of this Article] |