Differential Diagnosis for Swelling of Cheek, Lip, and Nose

Single Most Likely Diagnosis

• Cellulitis: This is the most likely diagnosis given the swelling of the cheek, lip, and nose without evidence of an abscess on CT scan. Cellulitis is a common bacterial skin infection that can cause redness, swelling, and warmth in the affected area.

Other Likely Diagnoses

• Dental Infection: Infections originating from dental sources can spread to the surrounding tissues, including the cheek, lip, and nose, causing swelling. The absence of an abscess on CT does not rule out a dental infection, as the infection could be in an early stage or not have formed a collection.
• Allergic Reaction: An allergic reaction, such as angioedema, can cause sudden swelling of the face, including the lips, cheeks, and nose. This condition can be triggered by various factors, including food, medications, or insect bites.
• Trauma: Facial trauma can lead to swelling due to inflammation and hematoma formation. Even without a visible wound, internal bruising could cause the observed symptoms.

Do Not Miss Diagnoses

• Ludwig's Angina: Although less common and typically associated with more severe symptoms, Ludwig's angina is a life-threatening condition that requires immediate attention. It involves a severe infection of the tissues in the neck and can cause swelling of the face, among other symptoms.
• Cavernous Sinus Thrombosis: This rare but potentially fatal condition involves a blood clot in the cavernous sinus and can be a complication of facial infections. Symptoms can include facial swelling, among others, and it requires prompt diagnosis and treatment.
• Necrotizing Fasciitis: A severe infection that affects the tissue beneath the skin and the fascia, a layer of tissue covering muscles. It's a medical emergency and can present with swelling, though it's less common in the facial area without other significant symptoms.

Rare Diagnoses

• Sarcoidosis: A condition that can cause inflammation in various parts of the body, including the face, leading to swelling. However, it's less likely to present acutely with swelling of the cheek, lip, and nose without other systemic symptoms.
• Granulomatosis with Polyangiitis (Wegener's Granulomatosis): A rare autoimmune disorder that can cause inflammation of the blood vessels and affect various organs, including the face, leading to swelling and other symptoms. It's a diagnosis of exclusion and typically presents with more systemic involvement.