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Case Report

Ludwig’s Angina in a Parturient: A Case Report

Ravi Madhusudhana, Ankitha Sunand, Ravi Madhusudana

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Indian Journal of Anesthesia and Analgesia 10(3):p 123-125, July-September 2023. | DOI: 10.21088/ijaa.2349.8471.10323.6

How Cite This Article:

Revathi Ashok, Ankitha Sunand, Ravi Madhusudana/Ludwig’s Angina in a Parturient: A Case Report/Indian J Anesth Analg. 2023;10(3) 123-125.

Timeline

Received : June 08, 2023         Accepted : July 31, 2023          Published : August 30, 2023

Abstract

Introduction: Ludwig’s angina is a rare but life threatening cellulitis of the soft tissue involving the floor of the mouth. Although Ludwig’s angina is a rare condition, it must be kept as a differential in the clinical setup when a patient presents with a neck swelling.

Case Report: A 28 year old multigravida with 31 weeks 4 days gestational age presented with a swelling over the right side of the neck since 8 days. Patient also complains of toothache since past 5 days. The swelling was sudden in onset and progressed to attain the present size. It was associated with breathing difficulty since past 1 day. It was also associated with pain over the region. She had difficulty in eating solid food due the restriction in mouth opening due to the swelling. She was on liquid diet since past 7 days. She was diagnosed with hypothyroidism and was on Tab. Thyroxine 50 mcg.

On physical examination, she is a moderately built and nourished female, vitals were stable. Examination of the head and neck revealed a diffuse swelling of size 10x10 cm over the right side of face extending from the right mastoid till the right oral commissure. Superiorly it extended up to 1 cm below right eye and inferiorly till the sternocleidomastoid origin.

Total leucocyte count of 5.59 thousand/mm3. After admission, antibiotics were started. Incision and drainage was planned for the patient. Intraoperatively, patient was tracheostomized due to restricted mouth opening and difficult intubation. After induction, vertical incision was made and about 100 ml of pus was drained from the swelling on the right side. Post-operative period was uneventful. The patient was discharged on antibiotics and tracheostomy care.

Conclusion: Ludwig’s angina should be kept in mind with this type of presentation. It can be life threatening if the treatment is improper, but intervention and subsequent correction can clear the symptoms completely.


References

  • 1.   Jurkat-Rott K, Lerche H, Lehmann-Horn F. Skeletal muscle channelopathies. J Neurol. 2002;249(11):1493-502.
  • 2.   Lin SH, Lin YF, Chen DT, Chu P, Hsu CW, Halperin ML. Laboratory tests to determine the cause of hypokalemia and paralysis. Arch Intern Med. 2004;164(14):1561-6.
  • 3.   Kelley DE, Gharib H, Kennedy FP, Duda RJ Jr, McManis PG. Thyrotoxic periodic paralysis. Report of 10 cases and review of electromyographic findings. Arch Intern Med. 1989;149(11):2597-600.
  • 4.   (Note: Extraneous text not belonging to the Kelley reference has been removed.)
  • 5.   Fontaine B, Vale-Santos J, Jurkat-Rott K, Reboul J, Plassart E, Rime CS, Elbaz A, Heine R, Guimaraes J, Weissenbach J, et al. Mapping of the hypokalaemic periodic paralysis (HypoPP) locus to chromosome 1q31-32 in three European families. Nat Genet. 1994;6(3):267-72.
  • 6.   AWang W, Jiang L, Ye L, Zhu N, Su T, Guan L, Li X, Ning G. Mutation screening in Chinese hypokalemic periodic paralysis patients. Mol Genet Metab. 2006;87(4):359-63.

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All raw data and code are available upon request.

Funding

This research received no funding.

Author Contributions

All authors contributed significantly to the work and approve its publication.

Ethics Declaration

This article does not involve any human or animal subjects, and therefore does not require ethics approval.

Acknowledgements

Information not provided.

Conflicts of Interest

The authors report no conflicts of interest in this work.


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Cite this article

Revathi Ashok, Ankitha Sunand, Ravi Madhusudana/Ludwig’s Angina in a Parturient: A Case Report/Indian J Anesth Analg. 2023;10(3) 123-125.


Licence:

Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


Received Accepted Published
June 08, 2023 July 31, 2023 August 30, 2023

DOI: 10.21088/ijaa.2349.8471.10323.6

Keywords

Dental cariesPeriodontal abscessPregnancytracheostomyFiberopticLudwig's angina

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Received June 08, 2023
Accepted July 31, 2023
Published August 30, 2023

licence


Attribution-Non-commercial 4.0 International (CC BY-NC 4.0)

This license enables reusers to distribute, remix, adapt, and build upon the material in any medium or format for noncommercial purposes only, and only so long as attribution is given to the creator.


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