A 40 year old woman presents with a tense, tender swelling in the upper neck with difficulty in breathing since two days. She is known to have diabetes mellitus - on oral hypoglycaemic agents with uncontrolled blood glucose levels.
The lateral radiograph of the neck shows a well-defined soft tissue swelling in the anterior aspect of neck extending to the floor of mouth. The swelling has numerous lucencies within it indicting foci of air.. There is mild impression on the suprahyoid airway.