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A woman with swelling of the neck
  1. Shinichiro Ienaga1,
  2. Akira Kuriyama2,
  3. Seigo Urushidani1
  1. 1 Department of Emergency Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
  2. 2 Department of General Medicine, Kurashiki Central Hospital, Kurashiki, Okayama, Japan
  1. Correspondence to Dr Akira Kuriyama, Department of General Medicine, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama 710-8602, Japan; nrk40448{at}nifty.com

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Clinical introduction

A 79-year-old diabetic woman presented with a 4-day history of trismus and progressive submandibular pain. Physical examination revealed a tender induration with redness in the submandibular region (figures 1 and 2).

Figure 1

Induration with redness in the submandibular region.

Figure 2

Induration with redness in the submandibular region.

Question

What is your differential diagnosis?

  1. Submandibular gland tumour

  2. Tetanus

  3. Viral submandibular adenitis

  4. Submandibular cellulitis …

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