Clinical Features

The most frequent acute clinical findings are facial swelling, pain, erythema, and trismus. 15 In chronic infection the patient may be afebrile but may complain of progressive trismus.15

Constitutional signs include fever, malaise, dehydration, dysphagia, nausea, or vomiting. In more advanced cases, systemic signs of sepsis are present.

History and physical exam features are variable. When infection occurs in the masseteric space, there is posteroinferior facial swelling with mild to moderate trismus. If the temporal space is infected, there is soft tissue swelling over the temporalis and significant trismus. Trismus without swelling suggests pterygomandibular space abscess.

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