Man with facial pain.

Department of Emergency Medicine, St. Luke's/Roosevelt Hospital Center, New York, NY.
Annals of emergency medicine (Impact Factor: 4.68). 03/2013; 61(3):278-88. DOI: 10.1016/j.annemergmed.2012.07.015
Source: PubMed
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    ABSTRACT: A 13 year review of patients diagnosed to have Ludwig's angina admitted to the Christian Medical College and Hospital, Vellore, India, between March 1982 and April 1995 is presented. The patients were either admitted to the ENT or paediatric surgical units. There were 41 patients, 24% being children and 76% adults. The clinical profile and outcome of these two groups were compared. In the paediatric group, none had dental caries while in the adult group, 52% had associated dental caries. In children, 70% were controlled with conservative medical management unlike the adults of whom 81% needed incision and drainage. Tracheostomy was necessary in 10% of the children and in 52% of the adults. The mortality was 10% in both groups.
    Clinical Otolaryngology 07/1997; 22(3):263-5. DOI:10.1046/j.1365-2273.1997.00014.x · 2.39 Impact Factor
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    ABSTRACT: The case is described of an occurrence of Ludwig's angina with advanced stage of the disease with progressive and rapid airway compromise and fatal consequence. A review of the literature is undertaken to gain a better understanding of the disease, and gives the opportunity for presenting a summary of the key issues regarding this dreaded disease, particularly the immediate management of it in the emergency department.
    Emergency Medicine Journal 04/2004; 21(2):242-3. DOI:10.1136/emj.2003.012336 · 1.84 Impact Factor
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    ABSTRACT: Ludwig angina is a rapidly progressing submaxillary, submandibular, and sublingual necrotizing cellulitis of the floor of the mouth that can have lethal consequences due to airway obstruction. Various aerobic and anaerobic microorganisms, and less often fungi, have been implicated to cause Ludwig angina, including oral flora such as streptococci and staphylococci. Early recognition and the use of parenteral antibiotics can prevent mortality and morbidity. We report a case of a 25-year-old white man who was admitted to the hospital by his dentist after being diagnosed with Ludwig angina secondary to periodontal abscesses involving teeth #17 and #32. Although antibiotics were administered, while in the hospital, the decedent had difficulty swallowing and was drooling. He suddenly began to have seizure-like activity thought to be anoxic myoclonus. The decedent was aggressively resuscitated and taken to the operating room for neck exploration and a tracheostomy. Neck exploration revealed severe necrotizing acute inflammation of the deep soft tissues and musculature of the neck. He remained on life support for 7 days until he was declared brain dead. Ludwig angina is a progressive cellulitis that often results in death by asphyxia. Ludwig angina can be complicated by subsequent deep neck infection. The underlying etiologies and common scenarios are examined, and significant autopsy findings and dissecting procedures are discussed. The pathophysiology of Ludwig angina is studied with a review of the current literature.
    The American journal of forensic medicine and pathology: official publication of the National Association of Medical Examiners 10/2008; 29(3):255-9. DOI:10.1097/PAF.0b013e31817efb24 · 0.70 Impact Factor
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