Int Arch Otorhinolaryngol 2014; 18 - a2456
DOI: 10.1055/s-0034-1388888

Ludwig Angina: A Case Report

Larissa Claret de Lima 1, Camillus Magalhaes Carneiro dos Santos 1, Fellipe Cunha Oliveira Pomar 1, Paulo Henrique Bicalho Barcelos 1, Sergio Bittencourt 1, Torcuato Sanchez Rojas Neto 1
  • 1Hospital Nossa Semhora de Lourdes

Introduction: The Ludwig Angina is an infectious process that consist in cervical connective tissue cellulitis and mouth floor, of polymicrobial nature, fast evolution, potentially lethal and, generally, by dental origin. The early diagnostic is fundamental to prevent the patients’ morbimortality. Moreover, the clinical diagnostic image exams are fundamental to adequately therapeutic face the Ludwig angina.

Objectives: The aim of this study is to report a case of Ludwig angina and the practice adopted.

Case Report: A 50-year-old patient (A.C.D.) presented submandibular and left anterior cervical bulging, associated with fever and dyspnea, initiating after dental procedure 15 days ago. The patient was held to neck tomography showing collection in submandibular space, mouth floor, visceral cervical space, and left carotid projecting to the upper mediastinum and displacing hypopharynx aerial column to right. Hemogram measured was 30,660 leukocytes and 2% of rod cells. After the parapharyngeal abscess diagnostic, the patient was submitted to abscess drain in surgical center, with orotracheal intubation by bronchoscopy. In drained material, culture had streptococcus constellatus and streptococcus pyogenes growing. The patient used metronidazole and ceftriaxone after the surgical procedure.

Conclusion: The Ludwig Angina is a severe pathology and demand emergency measures. The early surgical drain associated to wide spectrum antibiotic therapy is necessary for its treatment. The realization of image exam is indispensable to the cervical spaces infections, both in extension evaluation and infection therapeutic planning. We conclude that Ludwig Angina is a severe disease, requiring early intervention in their treatment.