Presentation
Severe pain and tenderness of the neck with associated swelling and fever. History of dental caries.
Patient Data
CT study shows multiple deep and superficial neck spaces infections namely involving submental, submandibular, mouth floor, visceral spaces, and right para-pharyngeal space in the form of edema and multiple air streaks with associated mass effect on the right side of the airway. Associated swollen epiglottis, subcutaneous fat stranding, and enlarged lymph nodes.
The green arrow points to the infection of the mouth floor, the yellow arrow points to the swollen epiglottis (epiglottitis), and the red arrow points to the mass effect on the airway.
Case Discussion
This is a case of Ludwig angina shows mouth floor and multiple neck spaces infections with airway compromise. Protection of the airway is the first line of treatment in these cases followed by aggressive IV antibiotics.
Case contribution by Dr. Mohamed Elthokaby
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