A 45-year-old woman presents to the emergency department with a 1-day history of gradually worsening fever, severe neck pain, and increasing difficulty breathing with inspiratory stridor. Her husband noticed her voice had become muffled and her breathing labored. She has a poorly controlled history of type 2 diabetes mellitus and morbid obesity, for which she takes no regular medications. Her temperature is 38.90C, blood pressure is 162/82 mmHg, pulse is 85/min, respirations are 24/min, and oxygen saturation is 96% on room air. The patient appears acutely distressed, drooling profusely, and her tongue is displaced superiorly and posteriorly, making speech difficult. Physical examination reveals brawny, non-pitting edema of the submandibular and sublingual spaces, extending to the anterior neck. Given these findings, what is the most likely diagnosis and the immediate critical intervention required to prevent respiratory complications?

A 52-year-old woman presents to a general medical ward with increasing difficulty swallowing and painful mouth movements for the past 24 hours. She recently had a molar extraction. Her medical history includes poorly controlled type 2 diabetes mellitus and chronic kidney disease stage 3. On examination, she is febrile at 39.2°C, hypotensive at 95/60 mmHg, tachycardic at 115/min, and tachypneic at 22/min. Oxygen saturation is 96% on room air. Oral examination reveals significant submandibular and sublingual swelling, with noticeable elevation of the tongue. Palpation of the anterior neck elicits tenderness and a firm, non-pitting swelling, with a hint of crepitus. Stridor is clearly audible, and her voice is muffled. Respiratory effort appears increased. Given these findings, what is the most likely diagnosis and the immediate critical management strategy?

A 35-year-old woman presents to an outpatient clinic with increasing neck pain and difficulty swallowing that began two days ago, following a recent dental extraction. She reports a low-grade fever, muffled voice, and general malaise. She denies any severe trouble breathing, but notes some mild stridor when lying flat. Her past medical history includes well-controlled type 2 diabetes. On examination, her temperature is 38.2°C, blood pressure 130/85 mmHg, pulse 95/min, respirations 18/min, and oxygen saturation 98% on room air. Physical exam reveals moderate submandibular swelling and tenderness, particularly on the right side, with overlying erythema and induration. Her tongue appears slightly elevated and displaced posteriorly. Oral pharyngeal exam is difficult due to trismus, but no obvious tonsillar exudates are seen. Given her presentation, what is the most appropriate diagnostic imaging and initial antimicrobial therapy?

A 62-year-old woman presents to her primary care physician for a follow-up visit, three weeks after being discharged from an urgent care clinic where she had an acute peritonsillar abscess (PTA) successfully drained and was prescribed a course of oral clindamycin. She reports that her sore throat and muffled voice have resolved, and she is now able to eat without difficulty. Her medical history includes well-controlled hypertension, chronic gastroesophageal reflux disease (GERD), and a history of significant alcohol use disorder which she states she has recently reduced. She denies smoking. The previous episode was her second peritonsillar abscess within the past 18 months, with the prior episode occurring on the contralateral side and also resolving with drainage and antibiotics. On physical examination today, her oropharynx appears largely normal, but there is subtle, persistent mucosal thickening and slight asymmetry in the region where the recent abscess was drained. There is no uvular deviation or trismus. She has palpable, mobile, non-tender bilateral cervical lymph nodes, approximately 1 cm in size. Considering her clinical presentation and risk factors, what is the most appropriate definitive diagnostic approach and long-term management strategy to consider for this patient?

A 22-year-old female presents to an urgent care facility with a 4-day history of progressively worsening sore throat, predominantly on the right side. She reports increasing difficulty swallowing solids and liquids, accompanied by a muffled voice that sounds like she is speaking with a "hot potato" in her mouth. For the past 24 hours, she has also noted mild difficulty opening her mouth fully. Her medical history is unremarkable, and she denies recent travel or sick contacts. On examination, her temperature is 39.2 0C, heart rate 108/min, blood pressure 118/76 mm Hg, and respiratory rate 18/min. She appears fatigued but in no acute respiratory distress. Oral examination reveals significant right tonsillar swelling with notable leftward deviation of the uvula. Palpation of the anterior cervical chain elicits mild tenderness. There is no visible rash or significant dental pathology. Which of the following is the most appropriate initial management strategy, and what is a potential severe complication if untreated?