Indiana University Infectious Diseases Fellowship
17 Feb,
8 tweets, 5 min read
#idboardreview 30 F 2nd/3rd molar pain now presents w/ fever, rapid bilateral cardboard swelling of neck, mouth open w/ tongue touching the palate. Diagnosis? #medEd #idmeded #IDTwitter 
#ludwigs #angina loose term for infections of sublingual, submaxillary & submandibular spaces, always bilateral, rapid indurated cellulitis w/o lymphadenopathy w/o abscess. Behind from floor of mouth
#ludwigs #angina 50-90% dental source mostly 2/3rd msndibular molars. Brawny, woody, cardboardlike submandibular swelling that doesn’t pit. Mouth open due to swelling of tongue.
#ludwigs eating/swallowing difficult, edema/swelling of glottis can lead to asphyxiation. airway obstruction feared complication: early intubation or tracheostomy required. Mouth flora: Strep sp/anaerobes:Ceftriaxone+flagyl or amp/sulbactam or clinda+FQ
Image ref: radiopaedia.org/cases/ludwig-a…
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