Given a patient with poor general condition, fever (axillary temperature 39.5º), bilateral submandibular swelling of six days' evolution, mouth pain and trismus, which of the following statements is correct?
This patient is in serious condition. The trismus and fever suggest a deep cervical space infection and that is not a game because the airway can become obstructed. Knowing this, options 1, 2 and 5 are out of place and I am left with 3 and 4. There may already be mediastinitis; after all, that is the natural history of cervical deep space infections, but answer 4 is more correct and besides, we are in the ENT block, the airway specialty. I like this question because it requires knowledge that is important in clinical practice.
The first diagnostic probability is carcinoma of the floor of the mouth with bilateral cervical metastases.
The therapeutic priority is to ensure the patient's nutrition.
We are almost certainly facing a mediastinitis.
We must consider as a priority the risk of airway obstruction.
We must perform as a first diagnostic measure a cytology by fine needle aspiration puncture.
This patient is in serious condition. The trismus and fever suggest a deep cervical space infection and that is not a game because the airway can become obstructed. Knowing this, options 1, 2 and 5 are out of place
This patient is in serious condition. The trismus and fever suggest a deep cervical space infection and that is not a game because the airway can become obstructed. Knowing this, options 1, 2 and 5 are out of place
This patient is in serious condition. The trismus and fever suggest a deep cervical space infection and that is not a game because the airway can become obstructed. Knowing this, options 1, 2 and 5 are out of place