To determine the diagnosis for this patient's toothache lasting one week, we will examine the symptoms and known medical conditions that could potentially match this presentation.
Ludwig's angina is an important condition to consider. It is a serious, potentially life-threatening cellulitis or connective tissue infection of the submandibular space. It typically results from an infection of the roots of the teeth that spreads to the floor of the mouth. Key points supporting this diagnosis include:
Submandibular Swelling: It is often associated with bilateral swelling under the jaw due to the accumulation of pus or extensive inflammation.
Pain: Patients experience significant pain in the affected area, often correlating with dental infections.
Dysphagia and Difficulty Breathing: As the infection spreads, it can cause difficulty swallowing and breathing due to swelling.
Contrast this with the other options:
Acute parotitis: Involves inflammation of the parotid glands, often causing swelling in front of the ear and is not primarily related to toothache.
Angioneurotic edema: This condition involves sudden swelling, usually due to allergic reactions, and doesn't typically result from a dental issue.
Parapharyngeal abscess: While also an infection, it typically results in lateral neck swelling rather than submandibular swelling following a dental infection.
Given these considerations, the diagnosis that best aligns with the patient's symptoms is Ludwig's angina, which is the correct answer.
