Abscess of the anterior belly of the digastric muscle has not been previously described and could pose a diagnostic and interventional dilemma. This case summarises the clinical, microbiological, radiological and surgical issues encountered and suggests learning points for clinicians posed with similar presentations. We recommend timely assessment by an appropriately trained clinician in either ear, nose and throat or oral and maxillofacial surgery, admission to a closely observable environment with airway-trained nursing staff and with potential for escalation to high dependency or intensive care in the event of airway compromise, as well as early involvement of an anaesthetist. Multimodality imaging should be performed to identify and localise an abscess collection or phlegmon, including an orthopantomogram in anticipation of odontogenic source and dental extraction as a definitive intervention. Surgical intervention for the abscess collection should be considered with consideration of the important neurovascular structures in this region.
Keywords: Abscess; Digastric; Floor of mouth; Neck; Neck muscles.