User:Mr. Ibrahem/Ludwig's angina
Medical condition / From Wikipedia, the free encyclopedia
Ludwig's angina is a type of severe cellulitis involving the floor of the mouth.[4] The condition is of rapid onset and worsens quickly.[4] Symptoms generally include fever, a raised tongue, neck swelling, pain, and trouble swallowing.[1] The floor of the mouth is often hard and there may be a decreased ability to open the mouth.[2] As the condition worsens airway compromise may occur.[1] Other complications may include mediastinitis and jugular vein thrombosis.[5]
Ludwig's angina | |
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Other names | Angina ludovici |
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Swelling in the submandibular area in a person with Ludwig's angina. | |
Symptoms | Fever, pain, raised tongue, trouble swallowing, neck swelling[1] |
Complications | Airway compromise[1] |
Usual onset | Rapid[1] |
Risk factors | Dental infection, upper respiratory infection, mouth piercing, poor immune function, diabetes, alcoholism[2][1] |
Diagnostic method | Based on symptoms and examination, CT scan[1] |
Treatment | Antibiotics, corticosteroids, endotracheal intubation, tracheostomy, surgery[1][2] |
Frequency | Rare[3] |
The majority of cases (70%) follow a dental infection, particularly from the molars, though it may also occur following an upper respiratory infection.[1][2] Other risk factors include piercing inside the mouth, poor immune function, diabetes, and alcoholism.[2] It specifically involves the submandibular, submental, and sublingual spaces and generally many types of bacteria are involved.[1][2] Diagnosis is generally made based on symptoms, though may be supported by CT scan.[1]
Prevention is by appropriate dental care including management of dental infections.[6] Initial treatment is generally with broad-spectrum antibiotics and corticosteroids.[1] In more advanced cases endotracheal intubation or tracheostomy may be required.[1] Other measures may include nebulized epinephrine and surgery.[2] The risk of death is about 8%; though is as high as 50% without treatment.[2]
Ludwig's angina is rare.[3] Both sexes are affected equally frequently.[7] It is named after a German physician, Wilhelm Frederick von Ludwig, who clearly described the condition in 1836.[8] However; earlier descriptions date back to the time of Hippocrates around 400 BC.[5] With the advent of antibiotics in 1940s, the rates of disease and risk of death was reduced.[5]