Septic Shock Secondary to Mediastinitis Due to Ludwig Angina after Dental Abscess: A Case Report

Introduction: The Ludwig angina is described as odontogenic cellulitis, which infrequently leads to upper airway obstruction or other complications such as cervical abscess, pericarditis, pulmonary abscess, mediastinitis, with an associated mortality.

Objectives: This study describes the case of a 25-year-old female patient, who was hospitalized presenting dental abscess, evolving to Ludwig Angina.

Resumed Report: A 25-year-old female patient was hospitalized presenting dental abscess, evolving to Ludwig angina and associated complication, such as submandibular and cervical abscess, pericarditis, pulmonary abscess, mediastinitis, and septic shock. The patient initially improved clinically after a broad-spectrum antibiotic therapy and surgical drainage of abscesses. However, there was a recurrence of the infection with ventilation-associated pneumonia, which evolved into septic shock, multiorganic dysfunction, and death.

Conclusion: Ludwig angina and deep neck infections are potentially lethal entities; the success of treatment is based on early diagnosis, use of adequate antibiotics, airway protection, and surgical drainage of infection.