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Right-sided neck pain in an intravenous drug user
  1. Cortlyn Brown,
  2. Paul Jhun
  1. Emergency Medicine, University of California San Francisco, San Francisco, California, USA
  1. Correspondence to Paul Jhun, Emergency Medicine, University of California San Francisco, San Francisco, CA 95104, USA; paul.jhun{at}

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Clinical introduction

A 48-year-old man with HIV, intravenous drug use and hepatitis C presented to the ED with right-sided neck pain for 2 days.

The patient injected methamphetamine into his neck 2 days prior to onset of pain. He reported dysphagia, odynophagia and subjective fevers. Physical examination of the neck was notable for induration and warmth overlying the right neck (figure 1). The oropharyngeal examination was unremarkable.

Figure 1

Photograph of the right side of the patient’s neck.


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  • Handling editor Edward Carlton

  • Twitter @jhunlikefun

  • Contributors CB and PJ conceived of the presented idea. CB wrote the manuscript with editing and supervision by PJ. All authors contributed significantly to the final manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient and public involvement Patients and/or the public were not involved in the design, or conduct, or reporting or dissemination plans of this research.

  • Provenance and peer review Not commissioned; internally peer reviewed.