see also: [[Lemierre's syndrome]], [[Parapharyngeal abscess]] see: [Rosen - odontogenic and deep neck infections](x-devonthink-item://645728DB-4B36-44DC-A117-83B80B325B16?page=5) cellulitis of submandibular space - usually bilateral - infection spreads rapidly into adjacent spaces including pharyngomaxillary and [[Parapharyngeal abscess|retropharyngeal spaces]] and the mediastinum # Clinical features - toothache - halitosis - neck pain - swelling - fever - dysphagia - elevation of tongue - trismus # Treatment > [!TLDR] : > - metronidazole and high dose penicillin OR flagyl + IV clinda if allergy > - may need intubation # causes - **dental caries** → spreading odontogenic infection - [[peritonsilar abscess]] # bugs - streptococci (40%) - S aureus (25%) - S epidermidis (20%) - anarobes (40%) eg bacteroides