Int Arch Otorhinolaryngol 2014; 18 - a2193
DOI: 10.1055/s-0034-1388856

A Case Report: Ludwig Angina Pacient with Odontogenic Focus

Paulo Tinoco 1, Aline Araujo Saraiva 1, Jose Carlos Oliveira Pereira 1, Lara Bonani de Almeida Brito 1, Pilar Campos Saavedra 1, Saulo Bandoli de Oliveira Tinoco 1
  • 1Hospital São José do Avaí

Introduction: Ludwig angina consists of a severe infectious inflammatory process, involving the sublingual and submaxillary spaces. It is generally odontogenic in origin and is characterized by firm tumefaction, diffuse, bilateral, and painful. It mainly occurs in men, young, and healthy people and has a polymicrobial nature. The patient presents fever, drooling, dysphagia, odynophagia, and trismus may also manifest with progressive respiratory obstruction, due to the supraglottic edema and dyspnea. Treatment with empirical therapy is done with antibiotics, surgical drainage with placement of Penrose drains, and maintenance of the upper airway. It can develop complications such as mediastinitis, bubpherenic abscess, pericardial and/or pleural effusion, empyema, osteomyelitis of the mandible, the carotid sheath infection, and suppurative thrombophlebitis of the internal jugular vein.

Objective: This study aims to report a case of Ludwig angina with odontogenic focus.

Case Report: A 28-year-old female patient, white, and originally from Itaperuna was referred to the Hospital São José do Avaí otolaryngology service 6 days ago. She presented with a headache, progressing swelling in submandibular region and face to the right with signs of inflammation, sore throat, dysphagia, drooling, trismus, and general fall. She presented a poor dental hygiene on orocopy. Blood count showed leukocytosis and was referred to the surgical center. Drainage was made with the placement of Penrose drain and a venous therapy with antibiotics was initiated. The patient progressed well and was subsequently referred to the odontologic service.

Conclusion: Ludwig angina consisted of a severe infectious inflammatory process, affecting the sublingual and submaxillary areas. It requires a fast intervention at the beginning, with empirical therapy done with antibiotics, and drainage. The patient progressed satisfactorily to the treatment. She is in dental treatment and outpatient.

Keywords: angina Ludwig, odontogenic, tumefaction.