12/18/2023 0 Comments Ludwig angina![]() ![]() ![]() ![]() If left untreated it can rapidly lead to an airway obstruction and death with an untreated mortality as high as 50 and mortality 8 for treated disease. Two patients had post-operative complications, but all recovered. Ludwig’s angina is a cellulitis of the floor of the mouth and soft tissues of the neck. Airway compromise is the leading cause of death in these patients 2. It was named after Karl Friedrich Wilhelm von Ludwig in 1836, who first described the fatal and rapidly progressive infection 1. Routine aerobic cultures were done on samples of drained material and the predominant microorganisms were Streptococcus species in two patients there were none in the other five. Ludwigs angina (LA) is a rapidly spreading infection involving the floor of the mouth. Ludwigs Angina (LA) is a rare infection of the submandibular space, which is a potential space consisting of the sublingual and submylohyoid space. High-dosage intravenous antibiotics directed towards the suspected causative microorganisms were given to all of the patients: two were treated successfully with conservative medical management, while seven underwent surgical drainage (a tracheotomy was necessary in one patient). It originates in the region of the submandibular gland with elevation and displacement of the tongue. In eight patients (89%) a dental infection appeared to be the underlying cause. Ludwig’s angina is best described by Karl Friedrich Wilhelm von Ludwig in 1836, as a rapidly and frequently fatal progressive gangrenous cellulitis and oedema of the soft tissues of the neck and floor of the mouth. We reviewed nine patients with Ludwig's angina between July 1996 and June 2002, all of whom presented with fever, neck swelling, bilateral submandibular swelling and elevation of the tongue. In the pre-antibiotic era, Ludwig's angina was frequently fatal however, antibiotics and aggressive surgical intervention have significantly reduced mortality. Ludwig's angina is caused by a rapidly expanding cellulitis of the floor of the mouth and is characterized by a brawny induration of the floor and suprahyoid region (bilaterally), with an elevation of the tongue potentially obstructing the airway. ![]()
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