Question

A patient has a history of a large carious lesion in a mandibular right molar, a severe toothache arising from the tooth, submandibular facial swelling on the right side, and a fever of 102.5 degrees Fahrenheit. This condition progressed over the next few weeks to include continuous purulent exudation through the gingival sulcus, right submaxillary lymphadenopathy, a constant fever of 100 degrees Fahrenheit, and a diffuse, "moth-eaten" radiolucent appearance of the posterior right side of the mandible. The most probable diagnosis is

A. histiocytosis.
B. Paget's disease.
C. acute osteomyelitis.
D. acute apical abscess.
E. chronic apical periodontitis.

Answer 1

The probable diagnosis for the patient with severe toothache, swelling, fever, and moth-eaten radiolucent appearance of the mandible is acute osteomyelitis.

Step-by-step explanation:

Given the symptoms described, such as a history of a large carious lesion in a mandibular right molar, severe toothache, submandibular facial swelling, fever, purulent exudation through the gingival sulcus, lymphadenopathy, and radiolucent appearance of the mandible, the most probable diagnosis is C. acute osteomyelitis. These symptoms suggest an infection has spread to and affected the bone, consistent with osteomyelitis. Acute osteomyelitis is a severe bone infection that often arises after a chronic tooth infection spreads beyond the tooth's root and into the surrounding bone.