Servicio de Cirugía Oral y Maxilofacial, Hospital Universitario Virgen del Rocío, Av. Manuel Siurot, 41013-Sevilla, Spain.
Med Oral Patol Oral Cir Bucal. 2010 Jul 1;15(4):e624-7. doi: 10.4317/medoral.15.e624.
Ludwig's angina is a serious and rapidly progressive infectious process that spreads through the floor of the mouth and neck. In this paper we present an infrequent case of a patient who suffered an odontogenic infection with poor response to the previous treatment, which evolved towards a Ludwig's angina combined with ketoacidosis in the context of a diabetes mellitus not known before. According to the literature reviewed, this case report represents the first contribution of a Ludwig's angina and ketoacidosis as an initial manifestation of a diabetes mellitus. The airway management, the antibiotic prescription and the surgical drainage allowed the healing of the patient without medical complications. Factors of co-morbidity like the diabetes mellitus together with focus tooth of infection may eventually turn into serious medical complications as the diabetic ketoacidosis and develop potentially lethal cervical infections.
路德维希咽峡炎是一种严重且迅速发展的感染性疾病，通过口腔和颈部底部传播。本文介绍了一例罕见病例，患者因牙源性感染而病情恶化，先前的治疗反应不佳，继而发展为路德维希咽峡炎，并伴有糖尿病酮症酸中毒，而此前患者并不知道自己患有糖尿病。根据文献回顾，本病例报告是首例以路德维希咽峡炎和酮症酸中毒为首发表现的糖尿病病例。气道管理、抗生素处方和手术引流使患者得以痊愈，无任何医疗并发症。合并症的因素，如糖尿病，以及感染的病灶牙，最终可能会导致严重的医疗并发症，如糖尿病酮症酸中毒，并发展为潜在致命的颈部感染。
