Challenge: What's the diagnosis?Related Questions:
1. What kind of tooth is that?
2. What's stridor?
First image in the public domain.
Monday, January 7, 2008
Van Beethoven
A 30 year old man presents to your emergency department complaining of severe pain in his mouth and an inability to swallow. He leans forward as he talks. He complains of a stiff neck and drooling. You note a fever and stridor on pulmonary exam. As you look into the oral cavity, you see that the tooth shown below has partially come out of the gums in the lower right jaw. There is swelling and stiffness of the jaw and sublingual space.
Challenge: What's the diagnosis?
Related Questions:
1. What kind of tooth is that?
2. What's stridor?
First image in the public domain.
Challenge: What's the diagnosis?Related Questions:
1. What kind of tooth is that?
2. What's stridor?
First image in the public domain.
Van Beethoven
ReplyDeleteThe tooth shown is a molar. Stridor is a high pitched sound in the upper airways indicative of a serious airway obstruction. In this case, the patient suffers from Ludwig’s angina due to a bacterial infection of the floor of the mouth (most often streptococci or staphylococci). The route of infection is usually through an infected third molar or infection of the gums around a partially erupted third molar. The infection is bilateral, involving both the submandibular and sublingual spaces. It is a rapidly spreading cellulitis without abscess formation or lymphatic involvement. Treatment involves maintenance of the airway and IV antibiotics.
Sources: Wikipedia, NetMedicine, UpToDate.