A previously healthy 17-year-old woman presented to our emergency department in August, 2009, complaining of sore throat, headache, neck stiffness, and left ear pain. Her symptoms had started 10 days earlier with sore throat, fever, and vomiting. On day 2 she telephoned the national Swine Flu Helpline and was advised to stay at home and take oseltamivir for suspected pandemic H1N1 influenza infection, which she declined. She attended her general practitioner's surgery with purulent left ear...