A 45-year-old male arrives in the emergency department with severe submandibular swelling, difficulty swallowing, and a muffled "hot potato" voice. Examination reveals firm bilateral swelling under the jaw and elevation of the tongue. What is the most likely diagnosis?
These findings are characteristic of Ludwig's angina-a rapidly spreading cellulitis of the floor of the mouth that often follows an infected lower molar. Bilateral submandibular swelling, tongue elevation, dysphagia, and a muffled voice indicate impending airway compromise. Peritonsillar abscess usually causes unilateral tonsillar swelling and uvular deviation. Epiglottitis causes severe sore throat with stridor, and mumps produces parotid gland swelling rather than floor-of-mouth cellulitis.
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BCEN CEN
Maxillofacial and Ocular Emergencies
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