Lateral Neck Fistula (Branchial Anomaly) vs. Lymphadinitis with Abscess
Left picture: Actually, a congenital neck fistula is present which is derived from the first branchial cleft, and which has a relation to the auricle and the auditory passage; from the tragus a fistula can be probed, in the depth of which an abscess has occurred with a secondary perforation at the angle of the lower jaw to the outside, which is shown in the picture at the bottom. Right picture: The diagnosis is a lymphadenitis with abscess, according to the fluctuation on palpation and the corresponding findings in the ultrasound.
In both patients a pathological finding is recognizable at the right angle of the lower jaw. Left picture: This finding reminds of granulation tissue with a fine crust. Right picture: This finding is very large, and the skin is inconspicuous except for a small reddened zone. Right picture: At first glance a lymphadenitis with abscess is considered. Left picture: This picture evokes the association of a chronic fistulous lymphadenitis, e.g. in cat scratch disease or atypical mycobacteria.