Pak Stella, Cha David, Meyer Chloe, Dee Christine, Fershko Adam
Internal Medicine, Kettering Medical Center.
Wright State University Boonshoft School of Medicine.
Cureus. 2017 Aug 21;9(8):e1588. doi: 10.7759/cureus.1588.
Ludwig's angina is a diffuse cellulitis in the submandibular, sublingual, and submental spaces, characterized by its propensity to spread rapidly to the surrounding tissues. Early recognition and treatment for Ludwig's angina are of paramount importance due to the myriad of complications that can occur in association with Ludwig's angina. Known complications of Ludwig's angina include carotid arterial rupture or sheath abscess, thrombophlebitis of the internal jugular vein, mediastinitis, empyema, pericardial effusion, osteomyelitis of the mandible, subphrenic abscess, aspiration pneumonia, and pleural effusion. By reporting a case of Ludwig's angina, we hope to raise the awareness in our medical community for this rare clinical entity. This case describes a 54-year-old woman with Ludwig's angina that evolved from a chronic odontogenic infection. She presented with perioral swelling with the involvement of bilateral submandibular and sublingual areas, accompanied by excruciating pain, chills, fever, and vomiting. She was treated with clindamycin and cefoxitin for infection and vigorously hydrated. This case is exemplary for the successful management of this potentially lethal clinical condition. Our early recognition and aggressive treatment helped to prevent complications from Ludwig's angina.
路德维希咽峡炎是一种发生于下颌下、舌下及颏下间隙的弥漫性蜂窝织炎,其特点是易于迅速蔓延至周围组织。鉴于路德维希咽峡炎可能引发众多并发症,早期识别和治疗至关重要。路德维希咽峡炎已知的并发症包括颈动脉破裂或鞘膜脓肿、颈内静脉血栓性静脉炎、纵隔炎、脓胸、心包积液、下颌骨骨髓炎、膈下脓肿、吸入性肺炎和胸腔积液。通过报告一例路德维希咽峡炎病例,我们希望提高医学界对这种罕见临床病症的认识。该病例描述了一名54岁女性,其路德维希咽峡炎由慢性牙源性感染演变而来。她表现为口周肿胀,双侧下颌下和舌下区域受累,伴有剧痛、寒战、发热和呕吐。她接受了克林霉素和头孢西丁治疗感染,并积极补液。该病例是成功治疗这种潜在致命临床病症的典范。我们的早期识别和积极治疗有助于预防路德维希咽峡炎的并发症。