Ludwig’s Angina

##plugins.themes.academic_pro.article.sidebar##

Published Nov 6, 2023
Download
pdf
Vol. 101 No. 8-9 (2023): Tunis med aug-sept 2023

##plugins.themes.academic_pro.article.main##

Hela Chaabouni
ENT department, La Rabta hospital, Tunis. Medical university of Sfax, Tunisia
Rim Bechraoui
ENT department, La Rabta hospital, Tunis. Medical university of Tunis, Tunisia
Maamoun Kriaa
ENT department, La Rabta hospital, Tunis. Medical university of Tunis, Tunisia
Rim Zainine
ENT department, La Rabta hospital, Tunis. Medical university of Tunis, Tunisia
Ghazi Besbes
ENT department, La Rabta hospital, Tunis. Medical university of Tunis, Tunisia

Abstract

Ludwig's angina is a severe diffuse cellulitis that presents an acute onset and spreads rapidly and bilaterally. It can affect the submandibular, sublingual or submental spaces resulting in a state of emergency. Early diagnosis and urgent management could be a life-saving procedure. We report a case of wide spread sialadenitis infection extending to the neck with trismus and elevation of the floor of the mouth that caused an obstruction of the airway and resulted in an inspiratory dyspnea and a stridor. The patient was directed to maintain the airway by elective tracheostomy. An appropriate use of parenteral antibiotics, airway protection techniques, and potential surgical drainage of the infection remain the standard protocol of treatment in advanced cases of Ludwig's angina. The aim of this case report is to emphasize on the importance of early diagnosis and appropriate management of Ludwig’s angina.

Keywords:

Ludwig’s angina, antibiotics, anaerobic bacteria, surgical decompression, tracheostomy

##plugins.themes.academic_pro.article.details##

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

References

  1. Candamourty R, Venkatachalam S, Babu MRR, Kumar GS. Ludwig’s Angina - An emergency: A case report with literature review. J Nat Sci Biol Med. 2012;3(2):206–8.
  2. Bansal A, Miskoff J, Lis RJ. Otolaryngologic critical care. Crit Care Clin. 2003;19(1):55–72.
  3. Moreland LW, Corey J, McKenzie R. Ludwig’s angina. Report of a case and review of the literature. Arch Intern Med. 1988;148(2):461–6.
  4. An J, Madeo J, Singhal M. Ludwig Angina. in StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 [cited 2022 Jan 16]. Available from: http://www.ncbi.nlm.nih.gov/books/NBK482354/
  5. Quinn FB. Ludwig angina. Arch Otolaryngol Head Neck Surg. 1999;125(5):599.
  6. Vallée M, Gaborit B, Meyer J, Malard O, Boutoille D, Raffi F, et al. Ludwig’s angina: A diagnostic and surgical priority. Int J Infect Dis. 2020;93:160–2.
  7. Okoje VN, Ambeke OO, Gbolahan OO. LUDWIG’S ANGINA: AN ANALYSIS OF CASES SEEN AT THE UNIVERSITY COLLEGE HOSPITAL, IBADAN. Ann Ib Postgrad Med: Annals of Ibadan Postgraduate Medicine. 2018;61–8.
  8. Brook I. Microbiology and principles of antimicrobial therapy for head and neck infections. Infect Dis Clin North Am. 2007;21(2):355–91, vi.
  9. Pak S, Cha D, Meyer C, Dee C, Fershko A. Ludwig’s Angina. Cureus. 2017;21;9(8):e1588.
  10. Spitalnic SJ, Sucov A. Ludwig’s angina: case report and review. J Emerg Med. 1995;13(4):499–503.