Mrs D consults her doctor with a sudden swelling of the right side of her face. She went to bed the night before with no hint of a problem, but when she woke up, she noticed the swelling. She can't recall any injury.
The swelling is mostly over the front part of her jaw towards her nose. Her right eye is almost completely swollen shut.
She has had no recent surgery and takes no chronic medicine. She does smoke.
On examination, the GP found the following:
- Swelling over the right side of the cheek extending towards and alongside the nose. The swelling is slightly tender.
- The patient has no loss of sensation, and except for the fact that the swelling makes movement of the facial muscles more difficult, it does not appear as if she has facial weakness.
Ears: slightly red tympanic membrane
Nose: normal
Throat: post nasal drip, no masses or swelling
Mouth: suspicious-looking right upper molar tooth.
The neurological examination is normal. All other systems are found to be normal on examination.
Her vital signs are as follows:
Temperature: 38,1
Pulse: 91
Blood pressure: 138/85
Based on the above, what is the most likely diagnosis, and what would be the appropriate management approach?
NOTE: Health24's on-site GP Dr Owen Wiese reveals new cases on Thursdays. The answer is posted with the story on Mondays, or you can get it in our Daily Tip – sign up here.
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