Prospective study of Ludwig’s angina and its management
Journal Title: Medpulse International Journal of ENT - Year 2017, Vol 5, Issue 2
Abstract
Background: Ludwig’s angina is a rapidly spreading, potentially fatal diffuse gangrenous cellulitis and edema of the soft tissues of the neck and floor of the mouth. The incidence of Ludwig’s angina is not uncommon albeit the advent of antibiotics and advanced dental care. Material and Methods: A total of 30 patients with the clinical diagnosis of Ludwig’s angina were enrolled in this prospective study. Various parameters like clinical features, comorbid conditions, complications and management options were analysed. Results: Maximum numbers of cases were seen below the age of 30 years with a slight male predominance. The most common presenting symptom was neck swelling(100%). The duration of symptom ranged from 2-20 days. Common clinical finding was neck swelling (90%) followed by caries teeth (80%). Dental infections (93.3%) were the most common underlying cause. 23.3% patients had history of diabetes mellitus, they were on irregular treatment. One patient (3.3%) had HIV infection. Necrotising fascitis was the only complication noted in this study, 5 patients out of 7 with diabetes mellitus developed necrotising fasciitis (71.4%). Conclusion: Early presentation of the patients to the hospital, energetic conservative management and early surgical intervention has decreased the complications and need for tracheostomy in our study. DM was the most common co morbidity associated, should be treated with high index of suspicion for impending fatal life hreatening complications like necrotising fascitis, even in less critical cases early surgical intervention should be carried out in these patients.
Authors and Affiliations
Tejaswini Honnegowda, C R Wilma Delphine Silvia
Keywords
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