Ludwig’s angina: Report of a case.

Abstract

A certain type of rapidly spreading gangrenous cellulitis was called Ludwig’s angina. We experienced a successful treatment of a patient with this infection, consisting of the general supportive therapy and immediate administration of high levels of antibiotics.

A 54-year-old woman was admitted to our clinic in severe distress because of a diffuse, indurated, submandibular and sublingual swelling of three days’ duration.

Examination disclosed the moderate hazard of airway obstraction, trismus, severe dysphagia and a temperature of 39.4℃. Local examination showed severe swelling of the floor of the mouth and elevated tongue.

Antibiotic therapy was started with Sodium Cephalothin 1g every 6 hours intravenously for four days, and Cephaloridin 1g every 6 hours intramuscularly for 14 days. Exploratory puncture proved pus formation on the 2nd day, then incision and tube drainage were performed. Thereafter, the patient improved steadily as indicated by reduction of temperature, cessation of drainage. Drainage continued for 14 days.

The patient was discharged in good condition after 20 days hospitalization.