Presentation
Neck swelling and pus discharge from mouth for one week, associated with hoarseness of voice and dysphagia.
Patient Data
Multi-loculated rim enhancing collections at the floor of mouth, which involves bilateral sublingual and submandibular spaces. Extension of these collections to subcutaneous region. Multiple air pockets noted within these collections.
Case Discussion
CT features are in keeping with Ludwig angina (cellulitis floor of mouth) complicated with multiple sites of abscesses. This infection has resulted in elevation and posterior displacement of the tongue resulting in partial stenosis of airway at oral cavity and oropharynx.
The etiology is most likely from odontogenic source (left lower third molar tooth region- recent extraction). Patient has background history of diabetes mellitus on insulin treatment, which was poorly controlled.
Patient went on to have incision and drainage for abscesses as well as vigorous intravenous antibiotics.
Pus culture isolated Klebsiella pneumoniae.
Unable to process the form. Check for errors and try again.