Differential Diagnosis for 18-year-old Male with Left Sided Facial Swelling
- Single most likely diagnosis
- Pericoronitis: This is an inflammation of the tissue surrounding a partially erupted tooth, often a wisdom tooth. The patient's history of impacted wisdom teeth, pain to the left gumline, and increasing pain with chewing support this diagnosis. The swelling and lack of improvement with ibuprofen also align with pericoronitis.
- Other Likely diagnoses
- Dental abscess: A localized collection of pus in the tissues surrounding the teeth, which could explain the pain, swelling, and lack of improvement with ibuprofen. The patient's history of impacted wisdom teeth increases the risk for dental abscesses.
- Gingivitis or periodontitis: Inflammation of the gums (gingivitis) or the tissues supporting the teeth (periodontitis) could cause pain, swelling, and difficulty with chewing. However, these conditions typically have a more gradual onset.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Ludwig's angina: A severe infection of the tissues in the neck, which can cause swelling, pain, and difficulty swallowing. Although the patient denies difficulty swallowing, Ludwig's angina is a life-threatening condition that requires prompt recognition and treatment.
- Parotid gland infection or abscess: An infection of the parotid gland, which is located near the jaw, could cause facial swelling and pain. This condition can be serious and requires prompt medical attention.
- Rare diagnoses
- Salivary gland tumor: A rare tumor of the salivary gland, which could cause swelling and pain in the face. However, this diagnosis is less likely given the patient's age and the acute onset of symptoms.
- Temporomandibular joint (TMJ) disorder: A condition affecting the joint that connects the jawbone to the skull, which could cause pain and swelling in the face. However, TMJ disorders typically have a more gradual onset and are less likely to cause significant facial swelling.