Differential Diagnosis for Unilateral Face Swelling

Single Most Likely Diagnosis

• Dental Abscess: This is often the most common cause of unilateral face swelling, typically resulting from a bacterial infection of a tooth. The swelling can be localized to the area around the infected tooth and can be accompanied by pain, fever, and difficulty opening the mouth.

Other Likely Diagnoses

• Cellulitis: A bacterial infection of the skin and subcutaneous tissues that can cause swelling, redness, and warmth of the affected area. It can be unilateral and affect the face.
• Parotid Gland Infection or Abscess: Infections of the parotid gland can cause swelling on one side of the face, often accompanied by pain and fever.
• Lymphadenitis: Inflammation of the lymph nodes, which can be caused by infection, can lead to unilateral swelling if the affected lymph nodes are located in the face or neck.

Do Not Miss Diagnoses

• Ludwig's Angina: A severe infection of the tissues in the neck, which can cause swelling of the face and neck and can lead to airway obstruction. It is a medical emergency.
• Cavernous Sinus Thrombosis: A rare but potentially life-threatening condition where a blood clot forms in the cavernous sinus, which can be a complication of facial infections. It requires immediate medical attention.
• Orbital Cellulitis: An infection of the tissues surrounding the eye, which can cause swelling of the face and eye area and can lead to serious complications if not promptly treated.

Rare Diagnoses

• Sarcoidosis: A condition that can cause inflammation and swelling in various parts of the body, including the face, though it is less common.
• Wegener's Granulomatosis (Granulomatosis with Polyangiitis): A rare autoimmune disorder that can cause inflammation of the blood vessels and lead to swelling and other symptoms in the face.
• Angioedema: A condition characterized by the rapid swelling of the skin and mucous membranes, which can be unilateral and affect the face. It can be life-threatening if it involves the airways.

Management

The management of unilateral face swelling depends on the underlying cause. For infections such as dental abscesses, cellulitis, and parotid gland infections, antibiotics are often prescribed. Supportive care, including pain management and hydration, is also important. In cases of abscesses, drainage may be necessary. For conditions like Ludwig's angina and cavernous sinus thrombosis, immediate hospitalization and aggressive treatment, including intravenous antibiotics and possibly surgical intervention, are required. Rare conditions may require specific treatments based on their underlying pathology. Always consult a healthcare professional for a proper diagnosis and treatment plan.