Assess for abscess versus hematoma of tongue: Left-sided tongue pain and swelling; ESBL E coli of buccal mucosa treated with 3 wks IV ertapenem (9/2015). There is now diffuse T2 hyperintensity and swelling with areas of relatively lower T2 signal within the left oral tongue and tongue base with extension into the submandibular space, floor of the mouth and buccal mucosa region. The mandible bone marrow signal appears to be unremarkable. There does not appear to be significant lymphadenopathy in the upper neck and the imaged portions of the major cervical flow voids appear to be intact. There is a left retinal hemorrhage with a hematocrit level. There is a right lens implant. There is scattered mild paranasal sinus mucosal thickening. The imaged intracranial structures are grossly unremarkable.
1. Findings suggestive of left oral cavity and tongue base inflammation, such a a form of Ludwig angina, without definite abscess formation, although the assessment is limited due to the lack of intravenous contrast, versus hemorrhage with associated edema.2. Left retinal hemorrhage .