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Emergency management of ludwig’s angina: a case report

  • Nur H. Alimin ,
  • Endang Syamsuddin ,


Objective: Ludwig’s angina is a severe diffuse cellulitis in mandibular region that commonly caused by odontogenic infection. Due to its acute on onset, spread rapidly, involving the submandibular, sublingual region bilaterally and submental region, this condition consider as an emergency because it can cause airway obstruction.Methods: A 40 years old male patient came to Dr. Hasan Sadikin hospital emergency room with pain and swelling at lower jaw, drooling, hard to breath and limitation in opening his mouth. He was diagnosed with sepsis and Ludwig’s angina. Tracheostomy was performed to secure the airway, continued with teeth extraction, incision and drainage to eliminate the source of infection. Combination of intravenous antimicrobial was administered.Results: An advanced case of Ludwig’s angina and its management was reported. The patient showed a good response to the treatment and the condition was improved.Conclusion: Ludwig’s angina is a rare emergency condition which potentially life-threatening. Patient showed a significant recovery due to immediate and rapid management in securing airway patency and infection source control to prevent the spread of infection and further complications.


  1. Barton ED, Bair AE. Ludwig’s angina. Selected topics; difficult airway. J Emer Med 2008;34: 163-169.
  2. Balasubramanian S, Elavenil P, Shanmugasundaram S, et al. Ludwig’s angina: a case report dan review of management. SRM J Res Dent Sciences 2014;5: 211-214.
  3. Ansari NA, Khyani IAM, Ahmed S, et al. Management of Ludwig’s angina: A multi centric study. Pakistan J Otolaryngol 2013;29: 3-5.
  4. Nagaria A, Malliwal A, Doshi CM, et al. Ludwig’s angina: a case report and review of airway management options. Indian J Basic and Applied Med Res 2015;4: 266-268.
  5. Hasan W, Leonard D, Rusell J. Ludwig’s angina- a controversial surgical emergency: how we do it. Case report. Int J Otolaringol 2011; 1-3.
  6. Kulkarni AH, Pai-Swarupa D, Bhattarai B, et al. Ludwig’s angina and airway considerations: a case report. Cases Journal 2008;1: 1-4.
  7. Melo TAF, Ricker T, Carmo MPD, et al. Ludwig’s angina: diagnosis and treatment. Literature Review Article. RSBO 2013;10: 172-175.
  8. Lemonick DM, Ludwig’s angina: diagnosis and treatment. Clinical review article. J Hosp Physician 2002; 31-37.
  9. Kuriyama T, Lewis MAO, Williams DW. Oral and maxillofacial surgery. In Andersson L, Kahnberg KE, Pogrel M, Anthony, editors.Infections of the oral and maxillofacial region. UK: Wiley-Blackwell Pub;2010.p. 512-513.
  10. Barton ED, Bair AE. Ludwig’s angina. Selected topics; difficult airway. J Emer Med 2008;34: 163-169.
  11. Doerr TD. Bailey’s head and neck otolaryngology. 5thed. In Jhonson JT, Rosen CA, editors. Odontogenic infections. Philadelphia: Lippincott Williams and Willkins; 2014.p. 777-778.
  12. Dellinger RP, Levy MM, Rhodes A, et al. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. J Crit Care Med 2013;41:585-586.
  13. Furst IM, Ersil P, Caminiti M. A rare complication of tooth abscess-Ludwig’s angina and mediastinitis. J Can Dent Assoc 2001;67: 324-327.

How to Cite

Alimin, N. H., & Syamsuddin, E. (2017). Emergency management of ludwig’s angina: a case report. Journal of Dentomaxillofacial Science, 2(3), 201–204.




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