Severe Ludwig angina

Case contributed by Dr Michael P Hartung

Presentation

Facial and tooth pain.

Patient Data

Age: 25 years
Gender: Male
CT

Extensive soft tissue infection on the floor the mouth, medial masseter spaces bilaterally, and extension of infection into the left parapharyngeal space and neck containing air, with air extending into the fascial planes near the left temporalis musculature. There is air dissecting into the duct of the left submandibular gland which appears enlarged and inflamed. There is also here insinuating about the left parotid gland. Reactive adenopathy. Swelling and narrowing of the pharynx, resulting in airway compromise. The posterior mandibular molars appear to be carious, but have intact roots without underlying osseous destructive changes.

Case Discussion

Severe presentation of necrotizing soft tissue infection of the floor of the mouth extending into the masseteric, parapharyngeal, and glandular spaces resulting in airway compromise. This requires urgent surgical attention and debridement. 

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Case information

rID: 86827
Published: 14th Feb 2021
Last edited: 15th Feb 2021
System: Head & Neck
Inclusion in quiz mode: Included
Institution: Tenwek Hospital

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