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An elderly woman presented with fever, sore throat, difficulty swallowing and substernal chest pain that radiated to her shoulder for 3 days. She was febrile (38.8°C), tachycardic (133 bpm), and hypotensive (85/54 mmHg). Physical exams revealed neck tenderness without lymphadenopathy and bulging of left pharyngeal wall. Laboratory exams revealed elevated both white blood cell count (19.25 K/μL) and C-reactive protein (16.19 mg/dL). Lateral X-ray …
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