Case Report: Ludwig's angina - 'The Dangerous Space'

TL;DR

A case report describes a rare but severe infection called Ludwig's angina, emphasizing the importance of early diagnosis and surgery to prevent life-threatening complications.

Contribution

The report highlights a successful clinical approach using prompt surgical decompression to avoid airway intervention in Ludwig's angina.

Findings

Prompt surgical decompression prevented the need for emergency airway intervention.

Early diagnosis and treatment led to immediate relief and avoided mortality.

Ludwig's angina was confirmed through clinical and radiographic evaluation.

Abstract

Background: Ludwig's angina is a potentially life-threatening disease characterized by diffuse bilateral cellulitis with an odontogenic origin. This unique infection is now rare owing to the antibiotic era.

Case: This patient presented to the emergency room with trismus, jaw and neck swelling, mild respiratory distress with tachypnea, hyperthermia, and panic. Clinical examination and radiographic evaluation confirmed the diagnosis of Ludwig's angina. As it is a quickly spreading infection, the patient was taken up for immediate surgical decompression leading to pus drainage, removal of the offending tooth, bacterial culture and sensitivity, and administration of empirical antibiotics. As we had operated promptly, there was no need for emergency airway intervention, and the patient had immediate relief from airway distress.

Conclusions: Early accurate diagnosis with conservative surgical decompression, thereby negating the need for airway intervention, was vital to avoiding mortality which is always possible in such an expeditious infection.

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