Clinical features associated with deep neck space infections and epiglottitis

Syndrome	Clinical features
Peritonsillar abscess (Quinsy)	Severe sore throat (usually unilateral), fever, ear pain, muffled voice, drooling, neck pain, and neck swelling. Trismus is common. Exam may show severely swollen or fluctuant tonsil with deviation of the uvula or bulging of the soft palate near the tonsil.
Submandibular abscess (Ludwig's angina)	Fever, rigors, mouth pain, drooling, dysphagia, and stiff neck. Floor of oropharynx may be elevated. Symmetric induration with palpable crepitus may be present in the submandibular area. Trismus is usually absent.
Retropharyngeal abscess	Severe sore throat and difficulty swallowing, often with antecedent history of penetrating trauma.
Parapharyngeal space infection	Fever, rigors, swelling below the angle of the mandible, medial bulging of the pharyngeal wall, and trismus. Dyspnea can result from swelling of epiglottis and larynx. Carotid sheath may be involved.
Suppurative jugular thrombophlebitis (Lemierre syndrome)	Persistent fever and sore throat, often despite antibiotics. Pulmonary emboli.
Epiglottitis	Sore throat (severity often out of proportion to exam), fever, muffled voice, drooling, stridor or respiratory distress, and hoarseness.

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