Differential Diagnosis
- Single most likely diagnosis
- Ludwig's Angina: This is a severe infection of the neck and floor of the mouth, characterized by a large, irregular gas-forming abscess. The location and extent of the abscess, as well as its involvement of multiple structures in the neck, are consistent with Ludwig's Angina. The fact that the abscess is abutting against the thyroid cartilage, left thyroid gland, and extends into the anterior chest wall also supports this diagnosis.
- Other Likely diagnoses
- Deep Neck Abscess: This is a broad term that refers to any abscess that forms in the deep tissues of the neck. The location and extent of the abscess, as well as its involvement of multiple structures, are consistent with a deep neck abscess. However, the specific characteristics of the abscess, such as its gas-forming nature and involvement of the parotid gland, make Ludwig's Angina a more specific and likely diagnosis.
- Parotid Abscess: The abscess is abutting against the anteroinferior margin of the left parotid gland, which suggests that the parotid gland may be the source of the infection. However, the extent of the abscess and its involvement of multiple structures in the neck make a parotid abscess a less likely diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Necrotizing Fasciitis: This is a life-threatening infection that can cause rapid destruction of tissue and can be fatal if not treated promptly. The presence of a large, gas-forming abscess and the involvement of multiple structures in the neck raise the possibility of necrotizing fasciitis, although it is not the most likely diagnosis.
- Lemierre's Syndrome: This is a rare but life-threatening condition that is characterized by a bacterial infection of the neck, typically caused by Fusobacterium necrophorum. The infection can cause a large abscess and can lead to sepsis and other complications. Although it is not the most likely diagnosis, it is a "do not miss" diagnosis due to its potential for serious complications.
- Rare diagnoses
- Actinomycosis: This is a rare bacterial infection that can cause abscesses and other tissue damage. The presence of a large, gas-forming abscess and the involvement of multiple structures in the neck raise the possibility of actinomycosis, although it is a rare diagnosis.
- Tuberculous Abscess: This is a rare type of abscess that is caused by Mycobacterium tuberculosis. The presence of a large, gas-forming abscess and the involvement of multiple structures in the neck raise the possibility of a tuberculous abscess, although it is a rare diagnosis.