Difference between revisions of "Ludwig's angina"

(Diagnosis)
(Source)
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==Source==
 
==Source==
Tintinalli
+
*Tintinalli
ER Atlas
+
*ER Atlas
  
 
[[Category:Peds]]
 
[[Category:Peds]]
 
[[Category:ENT]]
 
[[Category:ENT]]

Revision as of 15:26, 11 September 2011

Background

  • Infection of submandibular and sublingual spaces
  • 85% of cases arise from an odontogenic source, usually mandibular molars
  • Patients usually 20-60 yrs old, male predominance
  • Streptococcus, Staphylococcus, and Bacteroides spp. are pathogens
  • Intubation may be very difficult

Diagnosis

  • Mouth pain, drooling, trismus,brawny edema,tongue protrusion,stridor
  • Acute laryngospasm with airway compromise is biggest concern
    • Suggested by dyspnea or cyanosis
  • Clinical diagnosis, but CT with IVC can define abscess
    • May lose airway in scanner when pt lies flat
    • Weigh the risks and benefits

Treatment

  • Abx
    • Must cover typical oral flora
    • Usually third gen cehpalosporin with clindamycin or flagyl
  • Steroids controversial

Disposition

  • Admit, usually ICU for airway monitoring
  • Emergent ENT or OMFS consult

Source

  • Tintinalli
  • ER Atlas