Life-threatening complications of Ludwig’s angina: a series of cases in a developed country

2021 ◽  
Vol 14 (4) ◽  
pp. e240429
Author(s):  
Catarina Mendes Silva ◽  
Joana Paixão ◽  
Pedro Neves Tavares ◽  
João Pedro Baptista
Keyword(s):  
Developed Countries ◽  
Developed Country ◽  
Mortality And Morbidity ◽  
Space Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ludwig’S Angina ◽  
Reduction Of Mortality ◽  
Modern Era ◽  
Ludwig's Angina

Ludwig’s angina is a deep neck space infection defined as a rapidly progressive bilateral cellulitis of the submandibular space. In spite of being an uncommon entity in developed countries and the reduction of mortality and morbidity due to modern era of antibiotics, improved imaging and airway management, it is still an important and potentially life-threatening condition. The authors present 3 cases of Ludwig’s angina that occurred in a developed country, and that required admission in intensive care unit and extensive surgical and medical treatment.

Descending necrotizing mediastinitis from Ludwig’s angina: a life-threatening condition

2021 ◽  
Author(s):  
Miguel F. Carrascosa ◽  
Silvia Cayón Hoyo ◽  
Roberto Echeverría San-Sebastián ◽  
Iratxe Alcalde Díez ◽  
Sergio Tapia Concha ◽  
...  
Keyword(s):  
Descending Necrotizing Mediastinitis ◽  
Threatening Condition ◽  
Life Threatening ◽  
Ludwig’S Angina ◽  
Ludwig's Angina

Odontogenic deep neck space infection as life-threatening condition in pregnancy

2014 ◽  
Vol 59 (3) ◽  
pp. 375-378 ◽  
Author(s):  
D Dalla Torre ◽  
D Burtscher ◽  
D Höfer ◽  
FR Kloss
Keyword(s):  
Space Infection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Deep Neck Space Infection ◽  
In Pregnancy

scholarly journals Case Report: Poor oral hygiene leading to an emergency condition: A case report of Ludwig’s angina

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 1219
Author(s):  
Prashant Pant ◽  
Oshan Shrestha ◽  
Pawan Budhathoki ◽  
Nebula Devkota ◽  
Prabin Kumar Giri ◽  
...  
Keyword(s):  
Case Report ◽  
Oral Hygiene ◽  
Common Source ◽  
Poor Oral Hygiene ◽  
Presenting Symptoms ◽  
Dental Procedures ◽  
Life Threatening ◽  
History Of ◽  
Ludwig’S Angina ◽  
Ludwig's Angina

Ludwig’s angina (LA) is a rapidly spreading and potentially life-threatening infection having an odontogenic infection as the most common source. It involves the floor of the mouth and neck. Modernization in medical care has made this entity rare and of low mortality at the present but it is still feared as a lethal entity due to rapidly progressive airway obstruction that follows. Here we report a case of a 15-year-old male who suffered from LA. Presenting symptoms and findings of the examination helped in the clinical diagnosis. Immediate intubation, use of broad-spectrum antibiotics, and treatment of complications aided the patient’s recovery. LA should be considered for differential diagnosis in the case of neck swelling especially in those having a history of poor oral hygiene and recent dental procedures. Management of LA and its complications should always involve doctors from multiple disciplines.

Openness of Health Professionals about Death and Terminal Illness in a Nigerian Teaching Hospital

1997 ◽  
Vol 36 (1) ◽  
pp. 23-32 ◽  
Author(s):  
Kemi Adamolekun
Keyword(s):  
Terminal Illness ◽  
Terminally Ill ◽  
Developed Countries ◽  
Terminally Ill Patients ◽  
Aids Epidemic ◽  
Diagnosis And Prognosis ◽  
Threatening Condition ◽  
The Face ◽  
Life Threatening ◽  
Doctors And Nurses

Most physicians in developed countries are reported to have a sense of responsibility to inform a patient about the facts of his or her life-threatening condition. This study reports doctors' and nurses' responsibility to their terminally ill patients in an African environment. Since, by local tradition, doctors are not supposed to convey bad news and the patients do not see themselves as dying of illness, the doctors are not enthusiastic about informing the patients that their disease is terminal. Though doctors and nurses are of the opinion that patients or relatives should be informed of patients' diagnoses, the majority of these professionals do not discuss the prognosis with terminally ill patients. The need to discuss the diagnosis and prognosis according to the desire of each patient was examined. This is more relevant to the practice of medicine in the developing countries with the likelihood that more terminally ill patients would use the hospitals in the face of HIV/AIDS epidemic.

scholarly journals Maternal and foetal outcome of eclampsia in a referral hospital

2017 ◽  
Vol 6 (3) ◽  
pp. 1021
Author(s):  
Mousumi Das Ghosh ◽  
Vinita Singh ◽  
Alokananda Ray
Keyword(s):  
Antenatal Care ◽  
Early Recognition ◽  
Mode Of Delivery ◽  
Ventilatory Support ◽  
Adequate Treatment ◽  
Mortality And Morbidity ◽  
Foetal Mortality ◽  
Threatening Condition ◽  
Life Threatening ◽  
Foetal Outcome

Background: Eclampsia is a life-threatening condition, common in developing countries with high fatality rate. It is a cause of maternal and foetal mortality and morbidity. The aim of the study is to determine the maternal and foetal outcome in Tata Main Hospital, Jamshedpur, Jharkhand, India.Methods: All cases of eclampsia were analysed from January 2012 to December 2014 from admission to discharge or death of the patient.  Age, parity, antenatal care, interval between attack and admission, blood pressure on admission, gestational age and mode of delivery were  taken into account. There were 135 cases of eclampsia out of 14572 deliveries. Only singleton pregnancies were analysed.Results: The incidence of antepartum eclampsia was 84.4%, intrapartum 3% and postpartum 12.5 %. 83% patients were primigravida, 33% less than 20 yrs,42% had no antenatal checkup and 45% had < 4 visits. Only 15% patients received magnesium sulphate before referral to the hospital. There were four maternal deaths and twenty-one perinatal deaths. Eleven patients needed ventilatory support, four developed pulmonary oedema,  two patients had respiratory depression and three patients had renal failure.Conclusions: Hypertensive disease in pregnancy requires proper antenatal care, early recognition and referral, adequate treatment and timely delivery.

Surgical management of esophageal perforation: role of primary closure

2019 ◽  
Vol 27 (3) ◽  
pp. 192-198 ◽  
Author(s):  
Vu Huu Vinh ◽  
Nguyen Viet Dang Quang ◽  
Nguyen Van Khoi
Keyword(s):  
Hospital Admission ◽  
Esophageal Perforation ◽  
Primary Closure ◽  
Primary Repair ◽  
Time Interval ◽  
Mortality And Morbidity ◽  
Thoracic Level ◽  
Common Causes ◽  
Threatening Condition ◽  
Life Threatening

Objective Esophageal perforation is a life-threatening condition associated with high mortality and morbidity. Ambiguous clinical presentation is one of the most common causes of delayed and difficult diagnosis of esophageal perforation. In this retrospective single-center study, we reviewed the outcome of primary closure in patients with esophageal perforation between 2009 and 2017. Methods The data of 65 patients attending our department of thoracic surgery (from 2009 to 2017) for esophageal perforation were reviewed. Primary repair was attempted in 63 patients irrespective of the site of perforation and time interval between injury and hospital admission. In intrathoracic lesions, continuous mediastinal and pleural irrigation was undertaken, whereas in cervical perforations, gauze packing and local irrigation were performed. Jejunotomy was carried out in patients with inadequate healing. Results Of the 65 patients, 63 underwent primary closure and 2 were left to heal spontaneously. The majority of patients ( n = 44) had an esophageal perforation at the thoracic level, and only one was admitted early (<24 h after injury). Among the 63 patients managed with primary closure, 55 had satisfactory healing with one surgery. Healing was delayed in the other 10 patients. No mortality was reported. Conclusions Esophageal perforation can be well managed by primary closure, irrespective of the time interval between injury and hospital admission and the site of perforation. Conservative management might lead to an increased rate of complications such as empyema or necrotizing mediastinitis, and increased morbidity and mortality.

Airway Management in a Patient with Ludwig's Angina

2020 ◽  
Author(s):  
Sara B. Robertson
Keyword(s):  
Airway Management ◽  
Pediatric Patients ◽  
Signs And Symptoms ◽  
Thoracic Pain ◽  
Neck Infection ◽  
Airway Collapse ◽  
Life Threatening ◽  
Neck Anatomy ◽  
Ludwig’S Angina ◽  
Ludwig's Angina

Ludwig’s angina (LA) is a rare but life-threatening deep space neck infection that affects several combined potential spaces in the neck, namely the submental and submandibular spaces. Patients often present with signs and symptoms such as dysphonia, odynophagia, neck and thoracic pain, otalgia, sialorrhea, and cough. In later stages, the patient may present with dysphagia, trismus, cyanosis, dyspnea, and stridor which all may signal an impending airway collapse. This comprehensive review will set out to describe the definition, anatomy, and epidemiology of Ludwig’s angina, how it manifests, and how to diagnose and treat the infection that can be often difficult to recognize. Clinical features of the disease are discussed as well as different strategies for anesthesia and airway management. Two special situations in which Ludwig’s angina can occur—pregnancy and pediatric patients—are also covered. This review contains 5 tables, and 30 references. Keywords: Ludwig’s angina, management of the airway in Ludwig’s angina, conservative treatment in Ludwig’s angina, surgical management in Ludwig’s angina, antibiotic treatment for Ludwig’s angina, Ludwig’s angina in pediatrics, Ludwig’s angina in pregnancy, neck anatomy in Ludwig’s angina

scholarly journals Diabetic ketoacidosis in pregnancy

2018 ◽  
Vol 7 (7) ◽  
pp. 2945
Author(s):  
Rosália S. Coutada ◽  
Soraia S. Cunha ◽  
Elisabete S. Gonçalves ◽  
Ana P. Gama ◽  
João P. Silva ◽  
...  
Keyword(s):  
Type 1 Diabetes ◽  
Pregnant Woman ◽  
Diabetic Ketoacidosis ◽  
Perinatal Mortality ◽  
Aggressive Treatment ◽  
Mortality And Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
In Pregnancy

Diabetic ketoacidosis in pregnancy is a rare but potential life-threatening condition for the mother and the fetus. It tends to occur latter in pregnancy and is more common in patients with pregestational diabetes. Obstetricians should be aware of the events that can trigger diabetic ketoacidosis in pregnancy. Prompt recognition and aggressive treatment of this condition are essential in order to reduce perinatal mortality and morbidity. The authors present a case of a pregnant woman with type 1 diabetes with a poor surveillance of pregnancy and noncompliance to treatment that develops severe diabetic ketoacidosis at 34 weeks of gestation.

scholarly journals Successful completion of pregnancy in a woman with chronic granulomatous disease

2011 ◽  
Vol 4 (4) ◽  
pp. 174-176 ◽  
Author(s):  
Michi Hisano ◽  
Shinichi Kobayashi ◽  
Naoko Arata ◽  
Atsuko Murashima ◽  
Koushi Yamaguchi
Keyword(s):  
Chronic Granulomatous Disease ◽  
Antimicrobial Prophylaxis ◽  
Granulomatous Disease ◽  
Successful Completion ◽  
Mortality And Morbidity ◽  
Threatening Condition ◽  
Life Threatening ◽  
Fatal Illness

Chronic granulomatous disease (CGD) used to be a fatal illness of childhood and patients rarely survived past the first decade. Although antimicrobial prophylaxis has dramatically reduced mortality and morbidity in recent years, CGD remains a life-threatening condition. We present the successful obstetric course of a patient with CGD.

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