Somedays back there was a case in which some gave provisonal diagnosis as "LUDWIG'S ANGINA" so i think we should go for a revision. Therefore i got this please do comment esp. Freshers Ludwig's Angina is a severe form of cellulitis which usually arises from lower 2nd or 3rd molar infection. It involves the sublingual and submand spaces BILATERALLY, almost simultaneously and readily spreads into LAT. PHARYNGEAL &PTERYGOID Spaces may be extending to mediastinum. CLINICAL FEATURES: 1. Diffuse swelling. swelling is tense nd tender with charac board like firmness. Invlvd area is firm, painfull nd non-fluctuant. it does not pit on pressure. overlying skin is taut and shiny. 2. Fever. 3.Headache 4.Malaise 5. resp distress. pain and oedema will lead to diff in swallowing causing dysphagia nd also may cause asphyxia( diff in breathing).tongue may pushed to back of palate. 6. systemic- toxameia, Leucocytosis regional Lymph nodes are tender. Rapidly spreading submand nd subling. cellulitis with painful, BRAWNY swelling of upper part of neck and floor of the mouth with parapharyngeal space oedema spreading to glottis. PATHOLOGY: anaerobic bacteria. mainly haemolytic strep. staphylococci, bacteriodes, fusiform bacilli. MANAGEMENT. 1. Immed admission to hosp. 2.securing airway- TRACHEOSTOMY if necessary. 3. culture and senstivity testing. 4. agressive antibiotic treatment 5.drainage of sqelling to reduce pressure. COMPLICATIONS 1.dev of cavernous sinus thrombosis 2.meningitis 3.brain abscess 4.suppurative encephalitis, etc

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Thank you Dr. Shukla for such a brief and complete summary of Ludwig's angina or Ludovici. It is one of the dreaded emergency for Dental and ENT surgeons.

good one. Want to add one important point is that due to swelling there is fall back of tongue which result into severe respiratory arrest resulting into dreaded emergency as pointed by Dr Parvez..

yes ryt. i have added it that tongue is pushed bck leading to Asphyxia
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Thanks dr vidhi !! its bilateral involvement of the submandibular, sublingual and submental spaces simultaneously !!

great.. Thank you dr vidhi.. that was a very quick revision.. !!

one more main complication is respiratory distress.

its there...but in features...
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Very brif information thank u mam

good revision. thankx dr vidhi

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