Ludwig's angina: a case report with a 5-year follow-up

Aim: Ludwig's angina is a rare aggressive infection, often of dental origin, characterized by a rapid spread of cellulitis in the submandibular and sublingual spaces. Ludwig's angina is potentially fatal, if it obstructs the airways and if it is not treated with appropriate antibiotic therapy. Summary: The case report describes the diagnosis and the management of a Ludwig's angina caused by an endodontic infection in a 16 years-old female patient. The infection has been caused by a decay of the second lower right molar. After hospitalization and systemic antibiotic therapy, in accordance with the patient and the parents endodontic and restorative treatments of the tooth were performed. After 3 and 5 years, the radiological examination revealed no periapical lesions around right lower second molar and the presence of lamina dura. Key learning points: This aggressive infection may often be undervalued and this may cause dangerous consequences to the patient's life. The infection can be prevented by periodic dental care and interventions, which can avoid odontogenic infections. In the case of Ludwig's angina, early diagnosis is fundamental to save the patient's life. After the initial antibiotic therapy and once the life of the patient is no longer at risk, an appropriate endodontic therapy can be considered a valid therapy for this disease. (C) 2018 Societa Italiana di Endodonzia. Production and hosting by Elsevier B.V.