Ludwig's angina: case report in a teenager

Abstract

Background: Ludwig's angina (ADL) is an acute disease that rapidly evolves into submandibular cellulitis; without treatment, it can have fatal consequences. Few cases have been reported in Colombia; mortality is 10 % in the general population and 17 % in the pediatric population. It manifests with inflammatory changes in the floor of the mouth, generating facial edema, lingual protrusion, trismus, hypersalivation, odynophagia, and in severe stages, respiratory compromise. Case report: Teenage patient was admitted to the emergency department of a third-level hospital due to swelling, fever, and inflammatory changes in the neck and floor of the mouth, with a history of trauma five days before admission. An imaging study was carried out that confirmed the diagnosis, starting treatment with ceftriaxone and clindamycin. Subsequently, he evolved to an abscess, deciding to perform surgical drainage with complete resolution and recovery. Conclusions: Being a rare disease, it can present with respiratory compromise and complications such as abscesses, necrosis, or septicemia with lethal outcomes; the clinical evaluation guides the diagnosis; however, the imaging support is conclusive. Early antibiotic management and surgical drainage are the pillars of adequate intervention.