Ludwig’s Angina: Management of 32 Cases at Tertiary Care Hospital

Abstract

Background: Ludwig’s angina is a rapidly expanding cellulitis involving the floor of mouth and sub mandibular space predominantly due to dental / periodontal infections. Aim: To determine the management outcomes in the patients of Ludwig’s Angina. Place and duration of study: Department of Otorhinolaryngology Bahawal Victoria Hospital Bahawalpur. Duration was two years from August 2018 to July 2020. Study design: Hospital based cross sectional descriptive type of study Methodology: Patients of any age and gender who were clinically diagnosed as Ludwig angina and required hospitalization during the study duration were included in the study. Data regarding age, gender underlying cause, mode of presentation, treatment and complications were collected and analyzed. Patients with mild infection who did not require hospital admission were excluded from the study. Results: Out of total 32 cases, 20(62.5%) were males and 12(37.5%) were females. Age range was 10 to 70 years. In 28 (87.5%) cases, the cause was dental infection. All patients presented with pain and swelling of sub mandibular region. Four (12.5%) patients were improved with conservative treatment while 28(87.5%) underwent incision and drainage. Two (6.25%) patients needed tracheostomy. One (3.1%) patient developed complication (mediastinitis) and could not revive. Conclusion: Ludwig's angina is a disease of any age and gender commonly seen among the patients of preexisting dental infection. It can be life threatening if presented late with complication. Early diagnosis and aggressive treatment decrease morbidity and mortality. Key words: Angina, Ludwing, Cellulitis, Submandibular region.