PDF: Ludwig’s Angina - Emergency Treatment


Ludwig’s angina is a rapidly progressive, potentially fulminant cellulitis involving the sublingual, submental, and submandibular spaces. It may or may not involve parapharyngeal space.


The word Angina is derived from the Latin word angere which means to strangle.

Ludwig’s angina was coined after the German physician, Wilhelm Friedrich von Ludwig, who first described this condition in 1836 as a rapidly and frequently fatal progressive gangrenous cellulitis and edema of the soft tissues of the neck and floor of the mouth.

Other synonyms include angina ludovici, cynanche, carbuculus gangraenosus, morbus strangulatorius and angina maligna.


Despite the recent advances in therapy, rare and potentially life-threatening complications may still arise from time to time, and, as a result, account for significant morbidity and mortality.

We present a case of Ludwig’s angina, successfully managed at our hospital, with a brief review.

CASE REPORT 

A 55-year-old male presented with a chief complaint of inability to open the mouth, pain, and swelling in relation to the lower jaw and neck since a day. 

Patient revealed history of pain in left lower tooth region 4 days back and has taken treatment from local doctor (Tab. Combiflam twice a day), but the pain had not subsided.

Past medical, dental, and family histories were noncontributory.


On physical examination, he had respiratory distress and was toxic in appearance and his vital signs were monitored immediately. His temperature was 101.3°F with a pulse rate of 104 beats per minute, blood pressure of 140/90 mmHg, and a respiratory rate of 27 breaths per minute.

On extraoral examination, there was diffused swelling in the lower third of face measuring approximately 5 × 3 cm extending from left angle of mandible to right angle of mandible with bilateral involvement of the submandibular and sublingual spaces.





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