Sepsis in the Setting of Bilateral Submandibular Abscesses: A Case Report

Submandibular abscesses, a type of polymicrobial deep neck infection (DNI), are an otolaryngologic emergency due to the risk of airway compromise and septic shock. Unilateral submandibular abscesses are common and are often the result of odontogenic infections, while comorbidities that weaken the immune system, such as diabetes mellitus or human immunodeficiency virus (HIV), can exacerbate the infection. Bilateral submandibular abscesses are rare with limited cases reported in the literature, and are often associated with severe or systemic infections. This case report highlights the importance of a thorough physical examination and rapid intervention when evaluating a patient with suspected sepsis, presenting with nonspecific symptoms in the setting of multiple comorbidities. Rapid identification and appropriate management of a DNI such as bilateral submandibular abscesses is critical to preventing deterioration, including progression to sepsis, osteomyelitis, airway compromise, and death.