Abstract
Background. Ludwig's angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. Case. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig's angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. Conclusions. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. Furthermore, the healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child.
Highlights
Ludwig’s angina, named after the German physician who described the condition for the first time in 1948, is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death
Additional possible etiological factors include sialadenitis, compound mandibular fractures, or puncture wounds of the floor of the mouth [1]. While this is a life threatening infection, an extensive literature search did not yield much published information regarding this condition in the pregnant patient
The patient’s only significant medical history included history of anemia and sickle cell trait. She described that her pregnancy had been proceeding without difficulty, except for a three-day history of lower left quadrant tooth pain, and a one-day history of fever and chills
Summary
Ludwig’s angina is a rapidly spreading cellulitis that may produce upper airway obstruction often leading to death. There is very little published information regarding this condition in the pregnant patient. A 24-year old black female was admitted at 26 weeks gestation with tooth pain, submandibular swelling, severe trismus, and dysphagea, consistent with Ludwig’s angina. Her treatment included emergent tracheostomy, incision and drainage of associated spaces, teeth extraction, and antibiotic therapy. During a life threatening infectious situation such as the one described, risks of maternal and fetal morbidity include both septicemia and asphyxia. The healthcare provider must consider the risks that the condition and the possible treatments may cause the mother and her unborn child
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