Factors influencing Ludwig’s Angina

Abstract

Introduction: Ludwig‘s angina is a rapidly progressive, potentially fulminant cellulitis involving the sub-lingual, submental and sub-mandibular spaces. It typically originates from an infected or recently extracted tooth, most commonly the lower second and third molars. Besides, poor nutritional status, lack of proper medical supports are still major predisposing factors in developing Ludwig‘s angina in countries like Bangladesh. Aim: Our study aimed to observe etiological factors, clinical presentations, causative agents and treatment response. Method: We carried out a cross sectional study among 26 patients with Ludwig‘s angina admitted in the department of ENT and Head-neck surgery in Mitford Hospital from January- December-2012. Results: In this study we found that males are predominantly affected than females (22 males and 4 females, ratio-5.5:1) with odontogenic infection (15, 57%) as source. We found history of recent tooth extraction in 5 cases (19.2%) & organism was isolated from pus culture, Klebsiella in 5 cases (19.2%) out of 13 cases. In this study we found tooth cleaning habit of patients by tooth brush18 cases (69.2%). We elicited underlying systemic disease mainly Diabetes Mellitus in 4 cases (15.3%) and Chronic renal failure in some of our cases but could not reach in a conclusion as to whether systemic illness predisposes to Ludwig‘ angina. Conclusion: Our study suggests that prompt and thorough clinical evaluation and definitive care will considerably improve patient condition and reduce morbidity and mortality. DOI: http://dx.doi.org/10.3329/bjo.v20i1.22010 Bangladesh J Otorhinolaryngol; April 2014; 20(1): 5-7

Characteristics and outcomes of Ludwig's angina in patients admitted to the intensive care unit: A 6-year retrospective study of 29 patients

“… 10 Previous studies have shown that males are more likely to develop LA than females, with reported male: female ratios of patients with LA of 2.32:1 and 5.5:1. 11 , 12 In our study, the number of male patients with LA was also higher than the number of female patients with LA. The critically ill patients with LA in our study had a wide age range from 8 to 78 years, which is a wider age range than in previous studies of patients with LA.…”

Bacteriological Study and Antibacterial Susceptibility in Ludwig’s Angina in a Tertiary Level Hospital in Dhaka, Bangladesh

“…Mahmud et al and Fakir et al showed in their study 90% and 87% cases clinical presentation were more than two feature respectively. 6,16 In this study, most of the complications of Ludwig's angina were necrotizing fasciitis (8%) followed by septicemia (7%) and mediastinitis (6%). Two patients were died due to mediastinitis.…”

Antibacterial activity of stem bark extract of traditionally used Terminalia bellirica (Gaerth.) Roxb.

“…The extract of stem bark of Terminalia bellirica was tested for antimicrobial activity using agar disc diffusion method on solid media [7][8][9] . Luria agar was used as basal medium for Escherchia coli and Bacillus subtilis; and nutrient agar was used as basal medium for Pseudomonas aeroginosa, Staphylococcus aureaus.…”