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Age: 27

Sex: Male

Indication: Mouth pain, fever after dental extractions

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Case #2


Findings

  • Multiloculated peripherally enhancing fluid collection in the floor of the mouth which may extend from the root of the recently extracted left mandibular molar with adjacent edema of the mylohyoid muscle. The abscess extends inferiorly abutting the hyoid bone without bony destruction
  • Inflammatory changes track posteriorly into the left parapharyngeal space exerting mild mass effect on the oropharyngeal airway
  • Mild left lateral retropharyngeal edema without abscess, which exerts mild mass effect on the nasopharynx
  • Reactive lymphadenopathy
  • Multiple extracted teeth


Diagnosis

  • Ludwig angina, floor of mouth abscess

Sample Report

Multilocular floor of mouth abscess likely odontogenic in origin in the patient status post recent dental extractions. This infectious process may arise from the root of an extracted left mandibular molar. Extensive associated edema extends posteriorly into the parapharyngeal space with mild mass effect on the oropharynx. These findings are concerning for Ludwig angina. ENT consultation is recommended.

Associated mylohyoid myositis.

Mild left lateral retropharyngeal edema without abscess. No venous thrombosis.

Reactive lymphadenopathy.


Discussion





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