Spreading infection
Assess airway, swallowing, mouth opening, systemic signs and anatomical spread. Escalate urgently for red flags and source control.
Understand
Head and neck infection can progress from a local abscess to deep-space disease and airway compromise. A patient may deteriorate before dramatic external swelling appears.
Assess
Check voice, breathing, swallowing, drooling, trismus, floor of mouth, neck spread, observations and comorbidities. A rapidly evolving course is a red flag.
Apply
Arrange urgent emergency assessment for airway or systemic concern, with source control and supportive care. Do not send home a patient with progressive dysphagia on oral antibiotics alone.
Key distinctions
Deep infection can affect airway before oxygen saturation falls. Voice change, drooling, dysphagia, tongue elevation and rapidly increasing trismus should trigger urgent escalation. Consider systemic observations and immune status, but a normal temperature does not exclude serious disease. The source needs control, and the team may need anaesthetic, surgical and medical support in parallel.
Think through a case
A swelling with trismus, drooling and a changed voice is an emergency even if the patient has taken oral antibiotics for two days.
The distinction to remember
Do not let a normal-looking skin surface or a lack of fever override airway and swallowing red flags.
Test your recall
Why is progressive dysphagia concerning?
Show answer
It may indicate deep-space spread and airway risk.