A 71-year-old Filipino female with no known past medical history presented to an emergency department in Oakland, California, for neck swelling, fever, and difficulty breathing. She had been experiencing these symptoms for two weeks, with the neck swelling becoming progressively worse. On physical exam the patient appeared ill with a heart rate of 139, blood pressure of 87/36 and temperature 101.1, indicating septic shock. Physical exam revealed a large fluctuant mass over the left lateral neck. The center of this mass exhibited blackish discoloration and skin necrosis. Swelling and crepitus extended to the anterior and posterior neck, left shoulder and anterior chest wall.