Differential Diagnosis for 75 year old female with swelling of left jaw
- Single most likely diagnosis
- Dental abscess or infected dental cyst: Given the patient's history of facial cellulitis, recent antibiotic treatment, and the specific location of the swelling (left jaw), a dental infection is highly plausible. The fact that the swelling did not completely resolve and worsened after finishing antibiotics suggests a possible resistant infection or an infection that was not fully eradicated.
- Other Likely diagnoses
- Recurrent facial cellulitis: The patient has a history of facial cellulitis, and the current presentation could be a recurrence, especially if the previous infections were not fully resolved or if there is an underlying predisposing factor.
- Parotid gland infection or sialadenitis: Infection of the parotid gland could present with jaw swelling and pain, especially if the patient has a history of previous infections in the facial area.
- Osteomyelitis of the jaw: This is an infection of the bone and could be a complication of a dental infection or previous facial cellulitis, especially in an elderly patient with possible compromised immune status or poor dental health.
- 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 significant swelling and can lead to airway obstruction. It is a medical emergency and requires prompt recognition and treatment.
- Necrotizing fasciitis: A rare but deadly infection that affects the tissue beneath the skin and surrounding muscles and organs. It requires immediate medical attention and can be fatal if not treated promptly.
- Malignancy (e.g., oral cancer): Although less likely given the acute presentation, malignancy could cause jaw swelling and should be considered, especially if there are risk factors such as smoking or a history of oral cancer.
- Rare diagnoses
- Actinomycosis: A rare chronic bacterial infection that can cause swelling and pain in the jaw area, often associated with poor dental health or recent dental procedures.
- Sarcoidosis: A systemic disease that can cause swelling in various parts of the body, including the face and jaw, though it would be an unusual presentation for this condition.
- Temporomandibular joint (TMJ) disorders: While more commonly associated with pain and dysfunction of the jaw joint, severe cases could potentially cause swelling, though this would be less likely given the patient's history and symptoms.