A 50-year-old man presented to the emergency department of a teaching hospital in the UK with a midline swelling of the neck, chest pain, and fever. The swelling had been incised at another hospital two weeks previously, but after initial improvement it had increased in size and become more inflamed. He was taking flucloxacillin and phenoxymethylpenicillin prescribed by a general practitioner. His medical history included repair of a patent ductus arteriosus as a child. His temperature was 38.6°C and oxygen saturation 95% on air.
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