[38F] With swollen and red cheek, neck pain, and trouble swallowing

Patient Description

A 38-year-old female presents with swelling and redness in her left cheek, which is tender to touch and came on suddenly. She also reports pain in the left side of her neck, which is swollen and painful to touch, and difficulty swallowing since May 17th. The patient has been sticking to soft foods like grits, eggs, and yogurt due to swallowing difficulties. Additional symptoms include ear pain and ringing in the ears, but no discharge or drainage from the ear, and headaches. She has experienced fever but has not taken any medications or treatments for the swelling and fever. There are no changes in her voice, difficulty breathing, or shortness of breath. The patient has no recent dental work, injury to the area, or travel to areas where infections are more common. Her past medical history includes endometriosis, diagnosed in November. She has no chronic illnesses or conditions like diabetes or autoimmune diseases, and no allergies or adverse reactions to medications. Current medications include Clonazepam 1 mg twice a day, Oxycodone 5-325 mg once a day, Eccurfer 30 mg every other day, and Nortriptyline 10 mg every night.

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Arora's Assessment

What might be happening

Based on the information you have provided, here are some possible explanations for your symptoms:

  • Parotitis (Salivary Gland Infection): This is an infection of the salivary glands, often caused by bacteria or viruses. Symptoms can include swelling and redness of the cheek, pain, fever, and difficulty swallowing. The sudden onset and tenderness of your cheek swelling, along with fever, suggest this could be a possibility.

    • Treatment: Typically involves antibiotics if bacterial, warm compresses, staying hydrated, and sometimes massaging the gland to help with drainage.

  • Dental Abscess: An infection at the root of a tooth or between the gum and a tooth. This can cause swelling, redness, pain, and difficulty opening the mouth. Even without recent dental work, an undiagnosed dental issue could be the cause.

    • Treatment: Requires antibiotics and possibly drainage of the abscess by a dentist.

  • Cellulitis: A bacterial skin infection that can cause redness, swelling, and tenderness. It can spread rapidly and may be accompanied by fever.

    • Treatment: Requires antibiotics and sometimes hospitalization if severe.

  • Temporomandibular Joint (TMJ) Disorder: This affects the jaw joint and can cause pain, swelling, and difficulty opening the mouth. However, TMJ disorders typically do not cause redness or fever.

    • Treatment: Includes pain relievers, anti-inflammatory medications, and sometimes physical therapy.

What you can do

While it's important to consult a healthcare professional for a formal diagnosis and treatment, here are some steps you can take in the meantime:

  1. Apply Warm Compresses: Gently apply a warm compress to the swollen area to help reduce pain and swelling.
  2. Stay Hydrated: Drink plenty of fluids to stay hydrated, which can help with any infection.
  3. Maintain Oral Hygiene: Continue to brush and floss your teeth regularly to prevent any potential dental issues.
  4. Soft Diet: Continue eating soft foods to avoid aggravating the swelling and pain.
  5. Over-the-Counter Pain Relief: Consider taking over-the-counter pain relievers like ibuprofen or acetaminophen to help manage pain and reduce fever.
  6. Use MDandMe: Journal your symptoms, track your progress, and share your notes with your healthcare provider for a more comprehensive evaluation.

What you should look out for

Seek medical attention more urgently if you experience any of the following:

  • Increased Swelling or Redness: If the swelling or redness spreads or worsens.
  • High Fever: If your fever persists or gets higher (over 100.4°F).
  • Difficulty Breathing: If you start having trouble breathing or shortness of breath.
  • Severe Pain: If the pain becomes unbearable or significantly worsens.
  • Pus or Discharge: If you notice any pus or discharge from the swollen area.

Remember, while this advice can help manage your symptoms, it is crucial to see a healthcare professional for a formal diagnosis and appropriate treatment.

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3 mo ago

People Also Ask

What are the common causes of sudden cheek swelling and redness?

Common causes of sudden cheek swelling and redness include infections such as parotitis (salivary gland infection), dental abscesses, and cellulitis. Other potential causes could be allergic reactions or trauma, but these are less likely given the symptoms described.

How can I differentiate between a salivary gland infection and a dental abscess?

A salivary gland infection often presents with swelling and tenderness in the cheek, fever, and difficulty swallowing, while a dental abscess typically causes localized pain in the mouth, swelling, and sometimes difficulty opening the mouth. A dental abscess may also be associated with a specific toothache or gum swelling.

What home remedies can help alleviate symptoms of parotitis?

Home remedies for parotitis include applying warm compresses to the affected area to reduce pain and swelling, staying well-hydrated, maintaining good oral hygiene, and eating soft foods to avoid aggravating the condition. Over-the-counter pain relievers like ibuprofen or acetaminophen can also help manage pain and fever.

When should I seek urgent medical attention for facial swelling and fever?

You should seek urgent medical attention if you experience increased swelling or redness, a high fever (over 100.4°F), difficulty breathing, severe pain, or notice any pus or discharge from the swollen area. These could indicate a more serious infection or complication that requires prompt treatment.

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