A is the correct answer. Why?

Explanation

Ludwig angina is a life-threatening and airway-threatening diagnosis. It is common in patients with dental infections and patients who are immunosuppressed, such as those with diabetes. Patients will present with a fever, dysphagia, dysphonia, drooling, and tongue elevation, with erythema extending submentally and down the chest. This is often caused by a dental infection that extends into the submandibular space and down the connective tissue planes of the neck. This is a life-threatening diagnosis that can be supported with a CT scan with contrast and requires IV antibiotics, protection of airway, and ENT consultation.

Sinusitis (B) presents with pressure over the sinuses and sinus discharge that may be clear, yellow or green, or purulent. A complication of sinusitis could include a brain abscess, which would present with a fever, altered mental status, and possibly neurological deficits.

Streptococcal pharyngitis (C) presents with a sore throat, fever, odynophagia, tonsillar exudates, and palatal petechiae. A possible complication of streptococcal pharyngitis is poststreptococcal glomerulonephritis, which presents with oliguria, dark urine, an acute kidney injury, hypertension, and periorbital edema.

Trauma (D) to the oropharynx or head and neck area may inoculate bacteria into the region and cause Ludwig angina. However, this is an unlikely cause and is less common an etiology when compared to dental infections.