Peritonsillar abscess subsequently complicated by Ludwig's angina

Abstract

The images of this article are clinical pictures of peritonsillar abscess subsequently complicated by Ludwig's angina of a 68‐year‐old man.

Parapharyngeal and floor‐of‐mouth abscess secondary to tonsillar phlegmon: A rare and unusual cause of Ludwig's angina

“…The patient initially refused needle aspiration and developed submandibular erythema with swelling 5 days later, requiring submandibular incision and drainage as well as a 6-week course of intravenous and oral antibiotics. 13 In the present case, because initial CT imaging of the neck demonstrated a non-enhancing soft tissue abnormality within the parapharyngeal space and attempted needle aspiration of the peritonsillar space did not yield pus, a diagnosis of tonsillar phlegmon was made. Antibiotic therapy was empirically initiated following microbiology guidelines based on local epidemiology.…”

“…Rarely, from the parapharyngeal space, infections of tonsillar origin may spread into adjacent deep neck spaces such as the submandibular, parotid, and masticator spaces. 10 , 11 , 12 , 13 …”

“…The patient initially refused needle aspiration and developed submandibular erythema with swelling 5 days later, requiring submandibular incision and drainage as well as a 6‐week course of intravenous and oral antibiotics. 13 …”

“…Rarely, from the parapharyngeal space, infections of tonsillar origin may spread into adjacent deep neck spaces such as the submandibular, parotid, and masticator spaces. [10][11][12][13] F I G U R E 1 Contrast-enhanced computed tomography (CT) imaging demonstrating a soft tissue abnormality within the left parapharyngeal space adjacent to the oropharynx but without convincing evidence of enhancement, suggestive of an inflammatory phlegmon.…”

“…Matsuura describes a case of a 68‐year‐old gentleman with ulcerative colitis who presented with peritonsillar abscess complicated by Ludwig's angina. The patient initially refused needle aspiration and developed submandibular erythema with swelling 5 days later, requiring submandibular incision and drainage as well as a 6‐week course of intravenous and oral antibiotics 13 …”