ludwig's angina

INTRODUCTION AND IMPORTANCE OF CASE: Ludwig's angina is an inflammation of neck spaces making it immediately life-threatening. The infection spreads to adjacent planes destructing facial planes, aspirations of infective particles, or septic embolism to distant areas. Understanding the rare presentations will help early diagnosis and treatment. PRESENTATION OF CASE: This is about a 40 years-old man who presented with painful anterior neck swelling of 7 days duration...

OBJECTIVES: Severe odontogenic infections remain a challenge for maxillofacial surgeons. The aim of this work is to review the literature to provide an update of knowledge on the topic. METHODS: A comprehensive review of articles in PubMed, Web of Science and Africa Journals Online was performed through searching for "severe odontogenic infections." No language restrictions were applied. Only articles pertaining to treatment options were retrieved. Articles from the past 50 years were included...

A 48-year-old man with poorly controlled HIV presented with severe human monkeypox virus (hMPXV) infection, having completed 2 weeks of tecovirimat at another hospital. He had painful, ulcerating skin lesions on most of his body and oropharyngeal cavity, with subsequent Ludwig's angina requiring repeated surgical interventions. Despite commencing a second, prolonged course of tecovirimat, he did not objectively improve, and new lesions were still noted at day 24. Discussion at the UK National Health Service England High Consequence Infectious Diseases Network recommended the use of 3% topical and then intravenous cidofovir, which was given at 5 mg/kg; the patient made a noticeable improvement after the first intravenous dose...

Ludwig's angina is a fast-spreading cellulitis located on the floor of the oropharynx and neck (Tami, Othman, Sudhakar, & McKinnon, 2020). Patients may present with a wide range of symptoms depending on the severity of the condition (Reynolds & Chow, 2007). Emergency nurse practitioners need to promptly identify, diagnose, and treat patients with this problem, with close attention to the patient's airway. A compromised airway is the leading cause of mortality from this condition (McDonnough et al., 2019)...

Deep neck space infection (DNSI) is the infection of the potential space in the Neck; in this study our aim is to identify various aetiological causes, common site, bacteriology, and complications arising from it. DNSI is traditionally managed by prompt surgical drainage of the abscess followed by culture specific antibiotics. It is a prospective cross sectional type of study done conducted on 150 patients suffering from DNSI, it was conducted from March 2019 to March 2020 (1 year duration) at Department of ENT and Head & Neck Surgery, A...

PURPOSES: To determine if the empirical use of aminoglycosides is justified in Ludwig's angina based on microscopy, culture and sensitivity results. METHODS: A retrospective analysis was done on patients that presented with Ludwig's angina to the Maxillofacial and Oral surgery department at the University of Pretoria. Demographical data was extracted from patient files. Pus specimens that were submitted as part of the initial surgical intervention were analysed...

Deep neck space infection (DNI), is defined as infections in the deep fascia enclosing potential spaces of the neck. In the past the diagnosis and treatment of DNI have challenged. The health care personnel at all levels. The complex anatomy and the deep location of this region remains a big problem with significant risks of morbidity and mortality. The aim of this study is to analyse the difference in clinical presentation and microbiology of DNI in different age groups. Eighty two patients with DNI which were managed at the Department of Otorhinolaryngology, ABVIMS and Dr...

Deep neck space infections are really challenging to the otothinolaryngologist, intensivist and to the anesthetist for managing at a tertiary care center. Proper handling of such cases is needed in time to save the life of such patient. We reported a case 65 year female patient present with sudden onset of huge submental and submandibular swelling admitted in ICU with difficult intubation.

Anaesthesiologists have difficult airways to manage while treating patients with severe neck infections. Ludwig's angina patients who are unable to adequately control their airways may pass away. In this article, we go through the anaesthetic management during an emergency drainage procedure for Ludwig's angina. In severe cases of Ludwig's angina, awake fiberoptic intubation under topical anaesthetic is the most effective strategy to maintain the airway. An awake tracheostomy may be the best alternative when awake fiberoptic bronchoscopy is not possible...

We present an unusual case of Ludwig's angina secondary to a left tonsillar phlegmon in a previously fit and well 50-year-old woman. This tonsillar phlegmon spread along the peritonsillar/parapharyngeal plane to cause a diffuse cellulitis and collection in the submental, sublingual, and submandibular spaces despite empirical intravenous antibiotic therapy.

Ludwig's angina describes fulminant cellulitis involving the oro- and hypopharynx, which typically stems from bacterial pathogens, whereas "pseudo-Ludwig's angina" is ascribed to sublingual swelling due to noninfectious causes. There is a paucity of case reports implicating warfarin as the culprit for sublingual hematoma mimicking Ludwig's angina; however, we describe a novel case of apixaban-induced pseudo-Ludwig's angina, which was successfully managed with urgent surgical intervention and supportive care with antibiotic and glucocorticoid therapy...

Ludwig's angina is the rapidly progressive cellulitis of the soft tissue of the neck and the floor of the mouth. Airway compromise is a frequent and potentially fatal sequela of Ludwig's angina. Here we present a case of a 54-year-old African American male who presented with fever associated with painful swelling of the mouth and anterior neck. He was febrile and hypoxic on presentation. Imaging showed extensive involvement of the neck and mediastinum to the level of the clavicles. The diagnosis of Ludwig's angina of periodontal origin was made, and intubation was performed for airway protection...

Ludwig's angina is a bacterial infection of the tongue and floor of the mouth. It can be life-threatening if not treated promptly. Treatment includes IV antibiotics and, in some cases, surgical intervention. In this report, we describe a case with an unusual presentation. Early recognition of the condition in such cases is vital to prevent potential complications. LEARNING POINTS: Ludwig's angina, even though a well-established clinical entity, can be hard to recognize clinically.Early recognition of the condition is vital for the prevention of complications...

Ludwig's angina is a cellulitis that affects the submandibular, sublingual, and submental regions, fast-spreading along the fascial plane. Ludwig's angina has been classified as a fast-moving, frequently fatal gangrenous cellulitis or necrotizing fasciitis of the neck and mouth floor over the previous 2 centuries. A 60-years old male patient came with a chief complaint of swelling and pain in the neck that radiated to the chest with fever, headache, nausea, and history of toothache, poor oral hygiene, and diabetes mellitus...

Background and Objectives: Obligate anaerobic bacteria are known to cause various infections in human beings. We aimed to determine the prevalence and spectrum of obligate anaerobes encountered in pus aspirate, sterile fluids and tissue samples received for routine bacterial culture and sensitivity. Materials and Methods: A total of 160 samples including tissue, sterile body fluids and pus aspirate were collected, analysed for prevalence and spectrum of obligate anaerobes...

Ludwig's angina is a rapidly spreading, potentially fatal infection of deep fascial spaces of the neck leading to airway oedema and death. This, in recent times when associated with COVID-19 infection, possess treatment challenges making the patient susceptible to opportunistic infections with reduced healing potential. Owing to the multifactorial aetiology in our case and addressing them at the earliest, it is important to achieve favourable outcomes. The space infection that seeded with untreated trivial dental caries progressed to necrotising fasciitis of neck with mycobacterial growth on cartridge-based nucleic acid amplification test for tuberculosis testing...

Acute pharyngitis is a common complaint in emergency department (ED), urgent care, and primary care settings. Most cases are due to bacterial or viral infections easily treated with antibiotics or supportive care. However, serious pathologies in the pharyngitis differential include Ludwig's angina, peritonsillar abscess, retropharyngeal abscess, and bacterial tracheitis. Rarely, oncologic conditions such as leukemia may initially present as pharyngitis in an acute care setting. We present a case of pharyngitis in a 32-year-old male ED patient with a final diagnosis of acute myelogenous leukemia (AML)...

Introduction Ludwig's angina is cellulitis of submandibular space, submental space, and sublingual space. The main causative factors include dental infections (dental caries with atypical periodontitis, pericoronitis, and dental procedures). Other predisposing conditions include poor dental hygiene, dental caries, malnutrition, diabetes mellitus, AIDS, and various other immunocompromised states. It presents as an acute onset and spreads very rapidly causing bilateral diffuse neck swelling, edema of floor of mouth, pain, fever, trismus, foul-smelling pus discharge, difficulty in swallowing, airway edema, and tongue displacement creating a compromised airway with stridor...

We present three cases who presented to the emergency department with severe complications of dental infections: Ludwig's angina, necrotising fasciitis and peritonsillar abscess. All of our cases presented at the beginning of COVID-19 pandemic, with complications of dental infections. They delayed their dental treatment due to the pandemic. The airway management was difficult in our cases. Their mortality risk increased due to complications. We aimed to draw attention to complicated odontogenic infections which are rarely seen in emergency department in the past, however started to show up increasingly particularly at the beginning of the COVID-19 pandemic...

No abstract text is available yet for this article.