Ludwig's angina in a COVID positive patient—An atypical case report

T, Anish Poorna; Lokesh, J. R.; Ek, Joshna; John, Bobby

doi:10.1111/scd.12643

Cited by 5 publications

(4 citation statements)

References 19 publications

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“…Its progression to adjacent areas can lead to airway obstruction, necessitating emergent intervention. Odontogenic infections are the most common cause, accounting for 70% to 90% of cases [4][5][6]. The premolar is the most frequently implicated site of origin for Ludwig's angina [7].…”

Section: Discussionmentioning

confidence: 99%

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Life-Threatening Airway Obstruction and Septic Shock Due to Submandibular Space Infection: A Case Report

Mora,

Hamidullah,

Samaranayake

et al. 2023

Cureus

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Submandibular space infection, a rare and aggressive form of cellulitis, affects the floor of the mouth and neck, potentially leading to life-threatening complications. Although commonly associated with oral trauma and contiguous abscesses, the severity of these odontogenic infections often escalates due to underlying comorbidities. This report presents a unique case of a 74-year-old man who developed severe complications following an outpatient oral procedure. The patient exhibited fever and mouth swelling within a short time, which quickly advanced to impending airway compromise and septic shock. Diagnostic imaging revealed extensive swelling from the left submandibular region extending to the anterior neck and parapharyngeal space, effacing the airway. This necessitated immediate nasotracheal intubation and mechanical ventilation. Medical management comprised emergent antibiotic administration, airway protection, and admittance to the intensive care unit. This case underscores the potential severity of complications arising from an odontogenic infection in the presence of multiple comorbidities following an oral procedure. It emphasizes the need for prompt symptom recognition, emergency airway management, and the initiation of antibiotic therapy. Furthermore, this case illustrates the critical role of various imaging modalities and the choice of intubation technique in patients with an anticipated difficult airway. Despite the severity of submandibular space infection, a timely, effective, and multidisciplinary approach can mitigate fatal outcomes and improve patient prognosis.

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Section: Discussionmentioning

confidence: 99%

“…The inflammatory response following this procedure penetrated the sublingual ridge into the submandibular space, leading to significant clinical symptoms in this patient. Other causes of severe submandibular space infection include mouth floor trauma, sialadenitis, mandibular fractures, tonsillopharyngitis, and tongue piercings [3,4,7].…”

Section: Discussionmentioning

confidence: 99%

Life-Threatening Airway Obstruction and Septic Shock Due to Submandibular Space Infection: A Case Report

Mora,

Hamidullah,

Samaranayake

et al. 2023

Cureus

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“…It has been reported that cardiac arrest complications occur more frequently following difficult intubation 14. Blind nasal intubation is not suggested due to the risk of abscess rupture 15. If endotracheal intubation cannot be done in these patients, surgical airway management is recommended 16…”

Section: Discussionmentioning

confidence: 99%

“… 14 Blind nasal intubation is not suggested due to the risk of abscess rupture. 15 If endotracheal intubation cannot be done in these patients, surgical airway management is recommended. 16 …”

Section: Discussionmentioning

confidence: 99%

Complications of dental infections due to diagnostic delay during COVID-19 pandemic

Altıntaş

2022

BMJ Case Rep

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We present three cases who presented to the emergency department with severe complications of dental infections: Ludwig’s angina, necrotising fasciitis and peritonsillar abscess. All of our cases presented at the beginning of COVID-19 pandemic, with complications of dental infections. They delayed their dental treatment due to the pandemic. The airway management was difficult in our cases. Their mortality risk increased due to complications. We aimed to draw attention to complicated odontogenic infections which are rarely seen in emergency department in the past, however started to show up increasingly particularly at the beginning of the COVID-19 pandemic.

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