A 25-year-old woman presented to the ED with an acute onset of haemoptysis preceding sore throat of 3-day duration. There was neither recent foreign body ingestion nor throat trauma. She denied underlying haematological disorders. On clinical assessment, she was febrile with otherwise stable vital signs. No stridor or muffled voice was demonstrated. There were tender subcentimetre submandibular lymph nodes. Oral cavity examination is shown in figure 1. Her blood parameters, including cell count and coagulation profile, were within …