Pathology · patient case question
How is this soft tissue lesion best described?
Patient case: Spreading swelling of the upper face
Patient: 37-year-old man, emergency appointment.
Chief complaint: My face is swelling and it is getting worse quickly.
History: Two days of increasing swelling that began around an upper tooth. Now feels feverish and unwell.
Findings: Diffuse, firm, warm, erythematous swelling of the right upper face extending toward the medial canthus and lower eyelid. No fluctuance. Temperature 38.6°C. Grossly carious maxillary tooth with periapical tenderness.
Show answer and explanation
Correct answer: A. Cellulitis
- A. CORRECT. CELLULITIS is a diffuse, spreading, indurated infection of soft tissue with no defined pus collection. It is warm, erythematous, painful and firm rather than fluctuant, and it is the spreading quality that makes proximity to the eye dangerous.
- B. An abscess is localized, fluctuant and well-circumscribed — the opposite of the diffuse induration described.
- C. A mucocele is a benign salivary mucus-retention swelling, usually of the lower lip.
- D. Angioedema is soft, non-tender, non-erythematous and not associated with fever or a carious tooth.