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A case of Ludwig angina: a case report and review of the literature.
- Source :
-
The American journal of forensic medicine and pathology [Am J Forensic Med Pathol] 2008 Sep; Vol. 29 (3), pp. 255-9. - Publication Year :
- 2008
-
Abstract
- Ludwig angina is a rapidly progressing submaxillary, submandibular, and sublingual necrotizing cellulitis of the floor of the mouth that can have lethal consequences due to airway obstruction. Various aerobic and anaerobic microorganisms, and less often fungi, have been implicated to cause Ludwig angina, including oral flora such as streptococci and staphylococci. Early recognition and the use of parenteral antibiotics can prevent mortality and morbidity. We report a case of a 25-year-old white man who was admitted to the hospital by his dentist after being diagnosed with Ludwig angina secondary to periodontal abscesses involving teeth #17 and #32. Although antibiotics were administered, while in the hospital, the decedent had difficulty swallowing and was drooling. He suddenly began to have seizure-like activity thought to be anoxic myoclonus. The decedent was aggressively resuscitated and taken to the operating room for neck exploration and a tracheostomy. Neck exploration revealed severe necrotizing acute inflammation of the deep soft tissues and musculature of the neck. He remained on life support for 7 days until he was declared brain dead. Ludwig angina is a progressive cellulitis that often results in death by asphyxia. Ludwig angina can be complicated by subsequent deep neck infection. The underlying etiologies and common scenarios are examined, and significant autopsy findings and dissecting procedures are discussed. The pathophysiology of Ludwig angina is studied with a review of the current literature.
- Subjects :
- Adult
Anti-Bacterial Agents therapeutic use
Bacteroides isolation & purification
Brain Death
Deglutition Disorders etiology
Edema pathology
Enterococcus isolation & purification
Epiglottis pathology
Forensic Pathology
Gingiva pathology
Humans
Life Support Care
Ludwig's Angina diagnosis
Ludwig's Angina therapy
Lung microbiology
Male
Myoclonus etiology
Neck microbiology
Neck pathology
Neck Muscles pathology
Necrosis
Respiration, Artificial
Sialorrhea etiology
Subcutaneous Tissue pathology
Suppuration
Airway Obstruction etiology
Asphyxia etiology
Ludwig's Angina complications
Subjects
Details
- Language :
- English
- ISSN :
- 1533-404X
- Volume :
- 29
- Issue :
- 3
- Database :
- MEDLINE
- Journal :
- The American journal of forensic medicine and pathology
- Publication Type :
- Academic Journal
- Accession number :
- 18725784
- Full Text :
- https://doi.org/10.1097/PAF.0b013e31817efb24