Hard to Swallow

A 20-year-old woman is admitted to the hospital after presenting to the emergency department with pain in her throat and the left side of her neck, fever, foul-smelling breath, and an inability to clear secretions. She reports three recent bouts of nonbloody, nonbilious emesis, a deepening of her voice, and severe pain when she tries to open her mouth. The throat pain as well as malaise and occasional chills developed 10 days before presentation. . . .