Severe Ludwig angina
Facial and tooth pain.
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Extensive soft tissue infection on the floor the mouth, medial masseter spaces bilaterally, and extension of infection into the left parapharyngeal space and neck containing air, with air extending into the fascial planes near the left temporalis musculature. There is air dissecting into the duct of the left submandibular gland which appears enlarged and inflamed. There is also here insinuating about the left parotid gland. Reactive adenopathy. Swelling and narrowing of the pharynx, resulting in airway compromise. The posterior mandibular molars appear to be carious, but have intact roots without underlying osseous destructive changes.
Severe presentation of necrotizing soft tissue infection of the floor of the mouth extending into the masseteric, parapharyngeal, and glandular spaces resulting in airway compromise. This requires urgent surgical attention and debridement.