A 27-year-old man with pain, fever, marked swelling in the jaw, and inability to open mouth

odontogenic infection

The patient has Ludwig angina, which is a loose term that refers to a bilateral submandibular infection, characterized by "woody" or prominent induration, but usually without abscess formation. The infection most commonly arises from an odontogenic source, but it may also occur from peritonsillar abscess or suppurative parotitis. Patients typically present with fever, chills, drooling, and dysphagia. Treatment includes protection of the airway and antibiotics. Surgery may be necessary if fluid collections develop.

References:

Barton ED, Bair AE. Ludwig's angina. J Emerg Med. 2008;34(2):163-169.

Boscolo-Rizzo P, Da Mosto MC. Submandibular space infection: a potentially lethal infection. Int J Infect Dis. 2009;13(3):327-333.