Ludwig's Angina: A comprehensive analysis of diagnosis, treatment options, and their clinical correlations

Authors

DOI:

https://doi.org/10.33448/rsd-v12i10.43527

Keywords:

Infections; Ludwig's Angina; Infectious dermatopathies.

Abstract

Ludwig's Angina is a serious infectious condition that affects the facial and oral spaces of the stomatognathic system, presenting distinctive symptoms, such as stiffening of the floor of the mouth, dysphagia, dyslalia and risk of airway obstruction. Treatment of this pathological entity includes early diagnosis and maintenance of patent airways. The objective of the present work is to provide a comprehensive analysis that addresses the history, diagnosis, treatment and clinical implications of this disease, highlighting the importance of early diagnosis and appropriate treatment. The search was carried out through the National Library of Medicine (PUBMED) databases on September 26, 2023 and Scientific Electronic Library Online (SCIELO) on September 1, 2023, with the MeSH descriptors: “Ludwig's angina'', “Infections '' and ''Infectious Dermatopathies'' combined using the Boolean operator "AND", without limitations on language, publication date, gender or age of participants. During the search, 450 articles were found, resulting from 309 in SCIELO and 141 in PUBMED. Of these, 300 articles were initially read (reading the titles and abstracts) and, after exclusion criteria that included articles published after 1990, non-original articles, duplicates, errata, comments, letters and articles not made freely available in full, 36 articles remained selected. for complete reading, all meeting the inclusion criteria. The comprehensive analysis based on rigorous literature review provides essential information for the effective management of this condition, aiming to improve patients' quality of life and prevent serious complications.

References

Bernardoni, B., Grosso, R., Powell, E. & Tilney, P. V. et al. (2017). Case Study in Critical Care Transport: A 51-Year-Old Male With Ludwig Angina. Air Medical Journal, 36 (2):45-48. 10.1016/j.amj.2016.12.007.

Busch, R. F., & Shah, D. (1997). Ludwig's angina: improved treatment. Otolaryngology--head and neck surgery: official journal of American Academy of Otolaryngology-Head and Neck Surgery, 117(6), S172–S175. 10.1016/S0194-59989770093-7.

Bridwell, R., Michael G., Alex K., & Brit L. (2021). “Diagnosis and Management of Ludwig’s Angina: An Evidence-Based Review.” The American Journal of Emergency Medicine 41:1–5. https://doi.org/10.1016/j.ajem.2020.12.030

Bross-Soriano, D., Arrieta-Gómez, J. R., Prado-Calleros, H., Schimelmitz-Idi, J., & Jorba-Basave, S. (2004). Management of Ludwig's angina with small neck incisions: 18 years experience. Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery, 130(6), 712–717. 10.1016/j.otohns.2003.09.036.

Caccamese J. R., & Coletti, D. P. (2008) Deep neck infections: clinical considerations in aggressive disease. Oral Maxillofac Surg Clin North Am. 20(3):367-80. 10.1016/j.coms.2008.03.001.

Edetanlen, B. E., & Saheeb, B. D. (2018). Comparação dos Resultados no Tratamento Conservador versus Cirúrgico da Angina de Ludwig. Princípios médicos e prática : revista internacional da Universidade do Kuwait, Centro de Ciências da Saúde, 27(4), 362–366. 10.1159/000490740.

Freitas, C. F., Tucunduva, M. A. P. S., Ogassawara, B.; Baladi, M. G. & Neto, R. R. C. M. T. (2013). Estudo imaginológico de um caso de Angina de Ludwig. Rev de Odontologia da Cidade de São Paulo. 25(2): 164-169.

Fernandes, S. L., Ferreira, L. P. de S., Oliveira, M. A. de, Fernandes, G. C., Tieghi Neto, V., Santana, T. M., & Moretto, M. J. (2020). Complicações relativas às infecções odontogênicas: Angina de Ludwig. Journal of Multidisciplinary Dentistry, 10(1), 46–51. 10.46875/jmd.v10i1.33

Hisham, M., Sivakumar, M. N., Senthil Kumar, R. S., & Nandakumar, P. (2017). Angina de Ludwig: um pesadelo agravado pela reação adversa a medicamentos a antibióticos. Indian journal of critical care medicine: peer-reviewed, publicação oficial da Indian Society of Critical Care Medicine, 21(3), 179–181. 10.4103/ijccm. IJCCM_189_15

Hueb M. M., Borges, L. M., & Oliveira, L. R. (2004) Angina de Ludwig: tratamento cirúrgico minimamente invasivo guiado por ultrassonografia cervical. Rev Bras Otorrinolaringol. 8(3):279-86.

Kavarodi, A. M. (2011) “Necrotizing Fasciitis in Association with Ludwig’s Angina – A Case Report.” The Saudi Dental Journal 23(3):157–60. 10.1016/j.sdentj.2011.03.003

Lerner, D. N., & Troost, T. (1991). Submandibular sialadenitis presenting as Ludwig's angina. Ear, nose, & throat journal, 70(11), 807–809.

Lee, M. H., Carmichael, R. A., Read-Fuller, A. M., & Reddy, L. V. (2019). Fatal deep neck infection and respiratory arrest. Proceedings (Baylor University. Medical Center), 32(1), 67–69. 10.1080/08998280.2018.1533313.

Martins, L., Rocha, R. C. A., Santos, K. C. P., Marcucci, M., Costa, C., & Oliveira, J. X. (2009) Angina de Ludwig-considerações sobre conduta e relato de caso. Rev Inst Cienc Saude. 27(4):413-6.

Manasia, A., Madisi, N. Y., Bassily-Marcus, A., Oropello, J., & Kohli-Seth, R. (2016). Ludwig's angina complicated by fatal cervicofascial and mediastinal necrotizing fasciitis. IDCases, 4, 32–33. 10.1016/j.idcr.2016.03.001.

Mahdi, G., Hadi, M., Neda, A. & Hussein, K. (2017). Key factors of odontogenic infections requiring hospitalization: A retrospective study of 102 cases. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology. 29: 395-399. 10.1016/j.ajoms.2017.03.016

Moreland, L. W., Corey, J., & McKenzie, R. (1988). Ludwig's angina. Report of a case and review of the literature. Archives of internal medicine, 148(2), 461–466. 10.1001/archinte.148.2.461

Miller, C. R., Von Crowns, K., & Willoughby, V. (2018). Fatal Ludwig's Angina: Cases of Lethal Spread of Odontogenic Infection. Academic forensic pathology, 8(1), 150–169. 10.23907/2018.011

McDonnough, J. A., Ladzekpo, D. A., Yi, I., Bond, W. R., Jr., Ortega, G., & Kalejaiye, A. O. (2019). Epidemiology and resource utilization of ludwig's angina ED visits in the United States 2006-2014. The Laryngoscope, 129(9), 2041–2044. 10.1002/lary.27734

Osborn, T. M., Assael, L. A., Belle, R. B. (2008) Deep space neck infection: principles of surgical management. Oral Maxillofac Surg Clin North Am.20(3):353-365. 10.1016/j.coms.2008.04.002

Osaghae, I. P., Adetokunbo Rafel Adebola, Ibiyinka Olusola Amole, Ademola Abayomi Olaitan, Yussuf Ajibola Salami, Olasunkanmi Kuye, & Ashraf Ayoub. (2022). “Ludwig’s Angina in Nigeria: The Disease of the Poor and Health Inequality!” The Surgeon 20(4):e129–33. 10.1016/j.surge.2021.05.007.

Pereira A. S. et al. (2018). Metodologia da pesquisa científica. UFSM.

Pereira, D. E., Andrade, D. E., Resende, R. F. B. e Barros, R. R. (2019). Atualização sobre Etiologia e Terapia das Infecções Cervicofaciais de Origem Odontogênica. RFO - IJOSD. 52: 93-102. 10.22409/ijosd.v0i0.38509

Pourdanesh, F., Dehghani, N., Azarsina, M., & Malekhosein, Z. (2013). Pattern of odontogenic infections at a tertiary hospital in Tehran, iran: a 10-year retrospective study of 310 patients. Journal of dentistry (Tehran, Iran), 10(4), 319–328

Re Cecconi, D., & Roberto Fornara. (2018) “Ludwig’s Angina: A Case Report with a 5-Year Follow-Up.” Giornale Italiano Di Endodonzia 32(2):70–75.

1016/j.gien.2018.06.001

Sjamsudin, E., Manurung, B., Arumsari, A., & Maulina, T. (2020). The management of septic shock and Ludwig's angina: A case report of a life-threatening condition. SAGE open medical case reports, 8, 2050313X20930909. 10.1177/2050313X20930909

Topazian, R. G., Goldberg, M. H., & Hupp, J. R. (2006) Infecções orais e maxilofaciais. (4a ed.), Santos.

Vieira, F., Allen, S. M., Stocks, R. M., & Thompson, J. W. (2008). Deep neck infection. Otolaryngologic clinics of North America, 41(3), 459–vii. 10.1016/j.otc.2008.01.002

Published

15/10/2023

How to Cite

FARIA, H. V. dos S. .; D’DALARPONIO, P. de A. T. .; ABRÃO, B. M. .; DUARTE , A. F. .; CARVALHO, R. C. de .; DUTRA, M. B. F. .; JERONIMO , R. J. .; PEREIRA, L. G. .; MATOS, R. M. de .; SILVA, J. S. de Ávila .; OLIVEIRA, T. G. de .; OLIVEIRA, I. D. A. de .; CASTRO, M. F. de . Ludwig’s Angina: A comprehensive analysis of diagnosis, treatment options, and their clinical correlations. Research, Society and Development, [S. l.], v. 12, n. 10, p. e110121043527, 2023. DOI: 10.33448/rsd-v12i10.43527. Disponível em: https://www.rsdjournal.org/index.php/rsd/article/view/43527. Acesso em: 13 may. 2024.

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Section

Health Sciences