Abstract. Background: Ludwig's angina (LA) is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in. Abstract. Introduction: Ludwig's angina is often an infection of odontogenic origin affecting the soft tissues of the submandibular, sublingual and submental area. PDF | Ludwig's angina is a diffuse cellulitis in the submandibular, sublingual, and submental spaces, characterized Download full-text PDF.

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PDF | Ludwig's angina is a form of severe diffuse cellulitis that presents an acute onset and spreads rapidly, Download full-text PDF. Content. Ludwig's angina is observed infrequently in today's general practice. Ludwig's angina is a rapidly progressive bilateral cellulitis of the submandibular . View Large Image | View Hi-Res Image | Download PowerPoint Slide. Ludwig's Angina: An Analysis of Sixteen Cases in a Suburban Methods: All consecutive cases of Ludwig's angina seen and managed at the Obafemi.

Left pyriform sinus is also seen as obstructed Figure 1b. Neck MRI is performed with a clinical and radiological suspicion of LA and to be more confident about excluding a possible underlying malignancy.

Illustrative Cases

Neck MRI demonstrated subcutaneous soft tissue swelling and diffuse wall thickening of superior larynx, nasopharynx, oropharynx and hypopharynx Figure 1.

A cystic lesion with a 4. In the submandibular and jugulodigastric areas, multiple LAPs were seen whose short axis was greater than 2 cm with a thickening cortex was observed. A significant clinical improvement was seen after iv amikacin and prednisolone initiation in patient who underwent surgical debridement.

Cervical lymph node biopsies were reported as reactive hyperplasia on microscopic examination and surgically debrided tissue was pathologically confirmed as granulation tissue. Vancomycin and metronidazole were added to the antibiotherapy treatment and the patient was discharged with complete recovery.

Discussion LA was first described by Ludwig in as progressive gangrenous cellulitis and rapidly progressive and fatal infections of the soft tissues of the neck and floor of mouth [ 1 ].

One of the most frequent causes of LA is odontogenic-related [ 2 ].

The mostly encountered agents predominantly related to oral flora in LA are Streptococci, Staphylococci, Bacteroides and Fusobacterium spp. Before the invention of antibiotics LA was a mostly fatal infection; with the increased use of antibiotics fatality rates reduced but in the setting of spreading infection and edema via soft tissue may stil lead to end-stage airway obstruction, which could have devastating consequences [ 3 ]. Patients may have difficulty in breathing, swallowing.

And trismus, fever and tenderness in the submandibular region, neck pain can be seen.

Diagnosis is mainly based on clinical findings; radiologically marked edema and diffuse wall thickening can be seen in the affected submandibular region, submental area and floor of the mouth especially in MRI. Ann Surg. Ludwig's angina: an update.

Ludwig's Angina: A Rapid Radiological and Clinical Nightmare

Management of deep neck infection. Pediatr Clin North Am. Busch RF, Shah D.

Ludwig's angina: improved treatment. Otolaryngol Head Neck Surg. Ludwig's angina.

Clin Otolaryngol. Changing trends in deep neck abscess. A retrospective study of patients.

Steinhauer PF. Ludwig's angina: report of case in a day-old boy. J Oral Surg. Ludwig angina in children.

J Pediatr. Ludwig's angina following dental treatment of a five-year-old male patient: report of a case.

Associated Data

J Clin Pediatr Dent. A complication of tongue piercing.

Br Dent J.The published recommendations vary and are based on each author's personal experience and available resources. This condition has a rapid onset over hours.

Ludwig's Angina: The Original Angina

Vancomycin and metronidazole were added to the antibiotherapy treatment and the patient was discharged with complete recovery. Address correspondence to Richard W.

And trismus, fever and tenderness in the submandibular region, neck pain can be seen.

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