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Year : 2022  |  Volume : 24  |  Issue : 4  |  Page : 182-184

Mediastinitis, Pericarditis, Empyema, and Bacteremia: An Infrequent Complicated Ludwig's Angina Case

Department of Emergency Medicine, King Abdul-Aziz University Hospital, Jeddah, Saudi Arabia

Correspondence Address:
Dr. Diyaa Hassan Bokhary
King Abdul-Aziz University Hospital, Jeddah
Saudi Arabia
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/sjoh.sjoh_41_22

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Ludwig's angina is a life-threatening cellulitis of the submandibular, submental, and sublingual areas that originates mostly from odontogenic illnesses. It is associated with high morbidity and mortality rates. Its natural course, if not treated, leads to the rapid progression and development of complications, including airway compromise, necrotizing fasciitis, septic shock, pericarditis, and empyema. We report the case of a 40-year-old male who presented primarily with chest pain associated with cheek pain, sore throat, odynophagia, and subjective fever. The patient was diagnosed with Ludwig's angina secondary to a poor oral hygiene complicated by pericarditis, mediastinitis, and left-sided empyema. An immediate antibiotic administered, and subsequently neck dissection with left anterolateral thoracotomy was performed. In this case report, we highlight the importance of not only early recognition but also rapid intervention to prevent disease progression, including early empiric antibiotics, airway management, and surgical intervention, especially if the patient presents with an atypical or vague complaint.

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