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Ludwig's angina: a clinical review.

Abstract
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. In the pre-antibiotic era, Ludwig's angina was frequently fatal; however, antibiotics and aggressive surgical intervention have significantly reduced mortality. 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 eight patients (89%) a dental infection appeared to be the underlying cause. 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). 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. Two patients had post-operative complications, but all recovered.
AuthorsSomchai Srirompotong, Thumnu Art-Smart
JournalEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery (Eur Arch Otorhinolaryngol) Vol. 260 Issue 7 Pg. 401-3 (Aug 2003) ISSN: 0937-4477 [Print] Germany
PMID12937916 (Publication Type: Journal Article)
Chemical References
  • Anti-Bacterial Agents
Topics
  • Academic Medical Centers
  • Adolescent
  • Adult
  • Aged
  • Airway Obstruction (physiopathology)
  • Anti-Bacterial Agents (administration & dosage)
  • Child
  • Drainage (methods)
  • Female
  • Hospitalization
  • Humans
  • Ludwig's Angina (diagnosis, epidemiology, microbiology, physiopathology, therapy)
  • Male
  • Medical Records
  • Middle Aged
  • Mouth Floor (microbiology, pathology)
  • Retrospective Studies
  • Streptococcal Infections (complications)
  • Thailand

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