Masticator space infections

Background

• Consists of 4 contiguous potential spaces bounded by the muscles of mastication:
  • Masseteric, superficial temporal, deep temporal, pterygomandibular
• Bacteria gain entry to the space from dental infections, trauma, surgery, injections
• Spaces communicate with the tissue planes that extend down the neck to the mediastinum

Clinical Features

• Facial swelling and erythema
• Trismus
• Fever, malaise, dysphagia

Diagnosis

• CT with IV contrast

Differential Diagnosis

Facial Swelling

• Buccal space infections
• Dental problems
• Canine space infection
• Facial cellulitis
• Herpes zoster
• Masticator space infections
• Maxillofacial trauma
• Neoplasm
• Parapharyngeal space infection
• Salivary gland diagnoses
  • Parotitis
    • Bilateral parotitis
    • Suppurative parotitis
    • Viral parotitis (Mumps)
  • Ranula
  • Sialoadenitis
  • Sialolithiasis
• Superior vena cava syndrome

Treatment

• Clindamycin IV

Disposition

• Admit

Source

• Tintinalli