Ludwig's angina associated with mediastinal complications: Case report

Authors

DOI:

https://doi.org/10.33448/rsd-v9i9.7824

Keywords:

Ludwig's angina; Mediastinitis; Drainage; Airway handling.

Abstract

Ludwig's angina, considered a medical emergency, is an infection that affects the submandibular, sublingual, and submental spaces, presenting a course of rapid and potentially fatal evolution. The purpose of this report is to describe the treatment of a case of Ludwing's Angina, due to dental infection, associated with cervicofacial and mediastinal complications. The female patient appeared with a history of increased volume in the region in the bilateral and submental submandibular region, complaints of dysphagia, and dyspnea, in addition to trismus. The patient was initially treated employing drainage and extraction of the element that caused the infection, 72 hours after the operation, however, the patient returned to dyspnea. For the treatment of this complication, there was the option to perform cervicotomy associated with broad-spectrum antibiotic therapy. The therapeutic approach containing airway maintenance, cervicotomy, antibiotic therapy, as well as the removal of the etiological factor was effective for the management of this case of Ludwing's angina complication.

References

Andrade, E. L., Matsudo, S. M. M., Matsudo, V. K. R., Araújo, T. L., Andrade, D. R., Figueira Jr., A. J., & Oliveira, L. C. (1999). Nível de atividade física de adultos acima de 50 anos de idade do Estado de São Paulo. In: Anais XXII Simpósio Internacional de Ciências do Esporte. São Paulo, Brasil.

Bernardoni, B., Grosso, R., Powell, E., & Tilney, P. V. (2017). Case study in critical care transport: a 51-year-old male with Ludwig angina. Air medical journal, 36 (2), 45-48. doi: 10.1016/j.amj.2016.12.007

Brito, T. P., Hazboun, I. M., Fernandes, F. L., Bento, L. R., Zamppelini, C. E. M., Chone, C. T., & Crespo, A. N. (2017). Deep neck abscesses: study of 101 cases. Brazilian Journal of Otorhinolaryngology, 83, 341-8. doi: 10.1016/j.bjorl.2016.04.004

Bross-Soriano, D., Arrieta-Gómez, J. R., Prado-Calleros, H., Schimelmitz-Idi, J., & Jorba-Basave, S. (2004). Management of Ludwig’s an-gina with small neck incisions: 18 years expe-rience. Otolaryngology-Head and Neck Surgery, 130 (6), 712–717. doi: 10.1016/j.otohns.2003.09.036

Cardoso, L. L., Gasperini, G., Cardoso, L. C., Scartezini, G. R., Campos, A. I. M. S., & Marão, H. F. (2020). Successful Management of Ludwig’s Angina due to Dental Implant Displacement: A Rare Case Report. Case Reports in Dentistry, 2020, 6934286. doi: 10.1155/2020/6934286.

Dib, J. E., Squeff, F. A., Andrade, D. O., Ferreira, M. S., Dib, M. B. E., Dib, J. B. E., & Dib, V. B. E. (2016). Angina de ludwig com evolução para mediastinite. Relato de caso. Revista de Cirurgia e Traumatologia Buco-maxilo-facial, 16 (4), 30-35. Recuperado de: http://revodonto.bvsalud.org/scielo.php?pid=S1808-52102016000400006&script=sci_arttext

Edetanlen, B. E., & Saheeb B. D. ( 2018 ). Comparison of Outcomes in Conservative versus Surgical Treatments for Ludwig's Angina. National Library of Medicine. Recuperado de: https://pubmed.ncbi.nlm.nih.gov/29886486/

Fernandes, S., Ferreira, L., Oliveira, M., Fernandes, G., Neto, V., Santana, T., & Moretto, M. (2020). Complicações relativas às infecções odontogênicas: Angina de Ludwig. Journal of Multidisciplinary Dentistry, 10, 46-51. doi: 10.46875/jmd.v10i1.33

Hisham, M., Sivakumar, M. N., Kumar, R. S., & Nandakumar, K. P. (2017). Ludwig's angina: A nightmare worsened by adverse drug reaction to antibiotics. Indian Journal of Critical Care medicine, 21 (3), 179. doi: 10.4103/ijccm.IJCCM_189_15

Lee, M. H., Carmichael, R. A., Read-Fuller, A. M., & Reddy, L. V. (2019). Fatal deep neck infection and respiratory arrest. Baylor University Medical Center Proceedings, 32 (1), 67-69. doi: 10.1080/08998280.2018.1533313

Manasia, A., Madisi, N. Y., Bassily-Marcus, A., Oropello, J., & Kohli-Seth, R. (2016). Ludwig's angina complicated by fatal cervicofascial and mediastinal necrotizing fasciitis. ID Cases, 4, 32-33. doi: 10.1016/j.idcr.2016.03.001

Mcdonnough, J. A., Ladzekpo, D. A., Yi, I., Bond Jr., W. R., Ortega, G., & Kalejaiye, A. O. (2019). Epidemiology and resource utilization of ludwig's angina ED visits in the United States 2006–2014. The Laryngoscope, 129 (9), 2041-2044. doi: 10.1002/lary.27734

Mendonça, J. C. G., Masocatto, C., Oliveira, M. M, Santos, C. M., Macena, J. A., Teixeira, F. R., & Jardim, E. C. G. (2015). Infecção cervical grave de origem dentária: relato de caso. Archives of Health Investigation, 4 (6), 42-46. Recuperado de: http://www.archhealthinvestigation.com.br/ArcHI/article/view/918

Miller, C. R., Von Crowns, K., & Willoughby, V. (2018). Fatal Ludwig's Angina: Cases of Lethal Spread of Odontogenic Infection. Academic Forensic Pathology, 8 (1), 150-169. doi: 10.23907/2018.011

Pereira, A. S., Shitsuka, D. M., Parreira, F. J., & Shitsuka, R. (2018). Metodologia da pesquisa científica. [e-book]. Santa Maria. Ed. UAB/NTE/UFSM. Recuperado de: https://repositorio.ufsm.br/bitstream/handle/1/15824/Lic_Computacao_Metodologia-Pesquisa-Cientifica. pdf

Pereira, I. V., Andrade, L. S., Silva, F. M., Resende, R. F. B., & Barros, R. R. (2019). Atualização sobre Etiologia e Terapia das Infecções Cervicofaciais de Origem Odontogênica. Revista Fluminense de Odontologia, 52, 93-102. Recuperado de: https://periodicos.uff.br/ijosd/article/view/38509

Vassa, N., Mubarik, A., Patel, D., & Muddassir, S. (2019). Actinomyces turicensis: An unusual cause of cervicofacial actinomycosis presenting as ludwig angina in an immunocompromised host-Case report and literature review. ID Cases, 18, e00636. doi: 10.1016/j.idcr.2019.e00636

Published

06/09/2020

How to Cite

BARBOSA, L. M. .; NEGREIROS, J. H. C. N. .; NEVES, L. E. de M. .; PINTO, P. S. .; OLIVEIRA, L. M. L. de .; SILVA, M. L. de A. C. .; MONTEIRO, J. L. G. C. .; VIANA, R. de S. .; DINIZ, D. A. .; LAUREANO FILHO, J. R. . Ludwig’s angina associated with mediastinal complications: Case report. Research, Society and Development, [S. l.], v. 9, n. 9, p. e764997824, 2020. DOI: 10.33448/rsd-v9i9.7824. Disponível em: https://rsdjournal.org/index.php/rsd/article/view/7824. Acesso em: 22 nov. 2024.

Issue

Section

Health Sciences