[Report of 16 cases of Ludwig's angina: 5-year review].

Abstract

Ludwig's angina es a bilateral gangrenous induration of the connective tissues of the neck and floor of the mouth. It causes rapid airway obstruction and affects the submandibular, sublingual and submental spaces. The main causes of infection are usually the second and third molars. In severe or difficult cases, an early surgical procedure is often necessary. According to our experience on this entity, as gathered in five years (16 cases), the process has a dental origin. Two deaths were reported. Most cases were treated with crystalline penicillin G, metronidazole, dicloxacillin or amykacin; tracheotomy was performed on 12 patients, four other cases were treated with controlled breathing. The authors suggest antibiotic therapy, early surgery when needed, with a careful monitoring of airway symptoms to lessen the need of tracheotomy and reduce the death rate. Ludwig's angina should by no means go unnoticed in its early stages; early diagnosis should always be considered.