Ludwig Angina

Concurrent Ludwig’s Angina and Agranulocytosis: A Two-Case Series Highlighting Diagnostic and Therapeutic Challenges

“…LA typically results from odontogenic infections. However, its manifestation in agranulocytosis, especially drug-induced, is exceedingly rare and often atypical [ 1 , 2 ]. Neutropenic states alter the host response to infection, blunting classic signs such as pus formation or erythema.…”

Fatal airway obstruction due to Ludwig's angina from severe odontogenic infection during antipsychotic medication: A case report and a literature review

“…The fact that the swelling of her face and neck was not easily noticed due to obesity may have also contributed to the delay in detection of this fatal condition. On day X+12, the patient was already complaining of dysphagia, as she could only ingest water due to pain and swelling, which is an indication for early referral to a facility capable of airway management [16,17,20]. Furthermore, as a predisposing factor for severe odontogenic infections [1,11,17], the patient had a mental illness.…”

“…It first affects the submandibular tissues, causing asphyxia due to elevation and posterior deviation of the oral floor tissues [4,6,19]. Odontogenic infections account for 70% to 90% of cases of their etiology [9,11,14,20]. Other causes include peritonsillar abscesses, sialadenitis, mandibular fractures, intraoral injuries, and tongue piercing [6,9,11,19,21,22].…”

“…Odontogenic infections that cause Ludwig's angina are primarily infections of the second and third mandibular molars [5,6,11,21,23], because the roots of these teeth penetrate the mylohyoid ridge into the submandibular space. Thus, inflammation can spread contiguously from the submandibular space to the sublingual space and then to the pharyngeal, maxillary, and retropharyngeal cavities, encompassing the airway [6,7,11,14,19,20]. In this case, the infection was in the first premolar; to the best of our knowledge, there have been few reports in which the premolar was the only affected tooth responsible for the condition [24,25].…”

Ludwig's Angina: A Rapid Radiological and Clinical Nightmare

“…One of the most frequent causes of LA is odontogenic-related [2]. The mostly encountered agents predominantly related to oral flora in LA are Streptococci, Staphylococci, Bacteroides and Fusobacterium spp.…”