{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T11:19:21Z","timestamp":1787915961351,"version":"build-2784847793"},"reference-count":5,"publisher":"BMJ","issue":"8","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,20]]},"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:p>\n                    A man in his 40s presented with progressive tongue swelling and imaging findings of a right-sided deep neck fluid collection concerning for abscess. Despite empiric treatment with antibiotics and corticosteroids, there was no clinical improvement. Incision and drainage yielded purulent material and cultures grew\n                    <jats:italic>Cutibacterium acnes<\/jats:italic>\n                    , initially supporting an infectious aetiology. However, histopathological evaluation revealed metastatic keratinising squamous cell carcinoma involving lymph node tissue.\n                  <\/jats:p>\n                  <jats:p>Immunohistochemistry showed p40 positivity and p16 negativity, supporting a human papillomavirus-unrelated squamous cell carcinoma. Because of the patient\u2019s poor functional status, further oncological investigation was not pursued and palliative management was initiated.<\/jats:p>\n                  <jats:p>This case highlights a diagnostic pitfall in which metastatic squamous cell carcinoma may coexist with a culture-positive deep neck abscess. Positive bacterial cultures do not exclude underlying malignancy, and histopathological evaluation of tissue obtained during drainage remains essential, particularly in adult patients with atypical clinical presentations.<\/jats:p>","DOI":"10.1136\/bcr-2026-274269","type":"journal-article","created":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T10:55:22Z","timestamp":1787914522000},"page":"e274269","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Culture-positive neck abscess masking metastatic squamous cell carcinoma: a diagnostic pitfall"],"prefix":"10.1136","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4387-9727","authenticated-orcid":false,"given":"Yanina","family":"Nikolaus","sequence":"first","affiliation":[{"name":"Pathology, Marshall University Joan C Edwards School of Medicine, Huntington, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chander","family":"Khatri","sequence":"additional","affiliation":[{"name":"Internal Medicine, Marshall University, Huntington, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-9471-566X","authenticated-orcid":false,"given":"Gabriel","family":"Urbelz","sequence":"additional","affiliation":[{"name":"Internal Medicine, Marshall University, Huntington, West Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,8,28]]},"reference":[{"key":"2026082803551632000_19.8.e274269.1","doi-asserted-by":"publisher","DOI":"10.4065\/83.4.489"},{"key":"2026082803551632000_19.8.e274269.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.idc.2007.04.001"},{"key":"2026082803551632000_19.8.e274269.3","doi-asserted-by":"crossref","first-page":"305","DOI":"10.1017\/S0022215106000284","article-title":"Deep neck infection as the main initial presentation of primary head and neck cancer","volume":"120","author":"Wang","year":"2006","journal-title":"J Laryngol Otol"},{"key":"2026082803551632000_19.8.e274269.4","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0276544","article-title":"Diagnostic accuracy of contrast-enhanced CT for neck abscesses: A systematic review and meta-analysis of positive predictive value","volume":"17","author":"Hagelberg","year":"2022","journal-title":"PLoS One"},{"key":"2026082803551632000_19.8.e274269.5","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.20.00275"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-274269","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,28]],"date-time":"2026-08-28T10:55:28Z","timestamp":1787914528000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-274269"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8]]},"references-count":5,"journal-issue":{"issue":"8","published-online":{"date-parts":[[2026,8,28]]},"published-print":{"date-parts":[[2026,8]]}},"alternative-id":["10.1136\/bcr-2026-274269"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-274269","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8]]}}}