Diagnosis: Submandibular abscess
Treatment: Inpatient admission
The inpatient admission was medically necessary.
One indication of admission is failure of outpatient therapy, as noted by the insurance company as well as the Infectious Diseases Society of America's recommendations for the treatment of soft-tissue infections (1). However, when more critical structures are involved (such as those close to the airway), standard medical practice would preclude sending these patients home with PO (oral) antibiotics, because if they would fail, then the consequences are high (anoxia or death). The team was concerned about the dysphagia, and admitted with IV antibiotics, close observation, and steroids to decrease the swelling. Standard of care was followed in this case, and the patient recovered without any of the aforementioned complications.