Unusual Ludwig´s angina in systemic disabled patient related with periodontal disease





Infection control; Ludwig's angina; Periodontal diseases; Tooth extraction.


The Ludwig's angina is an infectious process involving submandibular, sublingual, and submental spaces bilaterally. They can rapidly progress to airway obstruction and hemodynamic instability. The most common cause of Ludwig's angina is apical dental infections, specifically involving the roots of second and third mandibular molars, which are contiguous to the submandibular space. Periodontal diseases are related with bone loss around dental roots and create a situation where the inflammatory drainage tends to assume a sulcular direction. The purpose of this article is to report a clinical patient with an unusual development of a periodontic-endodontic lesion leading to Ludwig's angina in patient whit diabetics, hypertension and chronic kidney disease. Thus, we can conclude that even if it is not common reports of angina associated with periodontal diseases we must attend to patient's correct care, initiating antibiotic therapy, maintenance of the airways, removal of infectious focus and control of comorbidities diseases.


Candamourty, R., Venkatachalam, S., Babu, M. R., & Kumar, G. S. (2012). Ludwig's Angina - An emergency: A case report with literature review. Journal of natural science, biology, and medicine, 3(2), 206–208.

Patterson, H. C., Kelly, J. H., & Strome, M. (1982). Ludwig's angina: an update. The Laryngoscope, 92(4), 370–378.

Kremer, M. J., & Blair, T. (2006). Ludwig angina: forewarned is forearmed. AANA journal, 74(6), 445–451.

Botha, A., Jacobs, F., & Postma, C. (2015). Retrospective analysis of etiology and comorbid diseases associated with Ludwig's Angina. Annals of maxillofacial surgery, 5(2), 168–173.

Parhiscar, A., & Har-El, G. (2001). Deep neck abscess: a retrospective review of 210 cases. The Annals of otology, rhinology, and laryngology, 110(11), 1051–1054.

Taub, D., Yampolsky, A., Diecidue, R., & Gold, L. (2017). Controversies in the Management of Oral and Maxillofacial Infections. Oral and maxillofacial surgery clinics of North America, 29(4), 465–473.

Costain, N., & Marrie, T. J. (2011). Ludwig's Angina. The American journal of medicine, 124(2), 115–117.

Edetanlen, B. E., & Saheeb, B. D. (2018). Comparison of Outcomes in Conservative versus Surgical Treatments for Ludwig's Angina. Medical principles and practice: international journal of the Kuwait University, Health Science Centre, 27(4), 362–366.

Huang, T. T., Liu, T. C., Chen, P. R., Tseng, F. Y., Yeh, T. H., & Chen, Y. S. (2004). Deep neck infection: analysis of 185 cases. Head & neck, 26(10), 854–860.

Kulkarni, A. H., Pai, S. D., Bhattarai, B., Rao, S. T., & Ambareesha, M. (2008). Ludwig's angina and airway considerations: a case report. Cases journal, 1(1), 19.

Genco R. J. (1996). Current View of Risk Factors for Periodontal Diseases. Journal of periodontology, 67 Suppl 10S, 1041–1049.

Rega, A. J., Aziz, S. R., & Ziccardi, V. B. (2006). Microbiology and antibiotic sensitivities of head and neck space infections of odontogenic origin. Journal of oral and maxillofacial surgery: official journal of the American Association of Oral and Maxillofacial Surgeons, 64(9), 1377–1380.

Boscolo-Rizzo, P., & Da Mosto, M. C. (2009). Submandibular space infection: a potentially lethal infection. International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases, 13(3), 327–333.




How to Cite

HADAD, H.; JESUS, L. K. de .; SANTOS, A. F. P. .; COLOMBO, L. T.; SILVA, N. P. .; RODRIGUES, L. G. de S.; MENDES, K. B.; SANTOS, G. M. dos; OLIVEIRA, G. A. G. de; MARTINS, E. P.; FABRIS, A. L. da S.; ARANEGA, A. M.; BASSI, A. P. F.; PONZONI, D.; FAVERANI, L. P.; FILHO, O. M.; GARCIA JÚNIOR, I. R.; SOUZA, F. Ávila. Unusual Ludwig´s angina in systemic disabled patient related with periodontal disease. Research, Society and Development, [S. l.], v. 10, n. 5, p. e22510514896, 2021. DOI: 10.33448/rsd-v10i5.14896. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/14896. Acesso em: 22 mar. 2023.



Health Sciences