Ludwig’s Angina, A Simple Guide To The Condition, Diagnosis, Treatment And Related Conditions

By Kenneth Kee

Ludwig's angina is a rare bacterial infection that infects the floor of the mouth.
It normally happens if a tooth infection is left not treated.
If the disorder is not promptly treated it can result in severe complications and can be fatal.
Ludwig's angina is an acute cellulitis in the area of the sub-mandibular gland.
It is most often because of sepsis in the throat or mouth which spreads to the sub-mandibular space.
Sometimes, it may be the effect of suppuration in the sub-mandibular gland itself.
Ludwig's angina, also called angina ludovici, is a serious, possibly life-threatening cellulitis, or connective tissue infection, of the floor of the mouth, normally happening in adults with concurrent dental infections and if left not treated, may block the airways, requiring tracheostomy
Ludwig's angina indicates the feeling of strangling, not the feeling of chest pain, though there may be chest pain in Ludwig's angina if the infection spreads into the retro-sternal space.
The life-threatening nature of this disorder normally indicates surgical treatment with involvement of critical care doctors such as those found in an intensive care unit
It often forms after an infection of the roots of the teeth (such as tooth abscess) or a mouth injury.
Ludwig's angina is bacterial in origin often caused by Streptococcus, Staphylococcus and Bacteroides species.
It is mainly caused by infection of the second and third molars as the roots of these teeth have direct entrance to the sub-maxillary space.
Other causes of Ludwig's angina are:
1. Dental abscesses
2. Dental injury or trauma can also produce Ludwig's Angina
3. Peritonsillar or parapharyngeal abscesses
4. Mandibular fractures
5. Oral lacerations and piercings
6. Oral cancer
Pre-disposing factors are:
1. Poor oral hygiene
2. Dental caries
3. Recent dental treatment or tooth extraction
4. Underlying systemic disorders such as diabetes, alcoholism, poor immunity, malnutrition etc.
Symptoms are:
1. Breathing difficulty
2. Difficulty swallowing
3. Drooling
4. Unusual speech (sounds like the person has a "hot potato" in the mouth)
5. Tongue swelling or protrusion of the tongue out of the mouth
6. Fever
7. Neck pain
8. Neck swelling
9. Redness of the neck
The doctor will do an examination of the neck and head to look for redness and swelling of the upper neck, under the chin.
The swelling may extend to the floor of the mouth.
The tongue could be swollen or out of place.
The patient may require a CT scan.
MRI with contrast and CT scan of the head and neck region are done for find out the extent of infection.
Fluid cultures are done for detection of the causative organism.
Treatments precedence is:
1. Airway safety,
2. Antibiotic treatment, and
3. Surgical drainage.
A breathing tube may need to be placed through the mouth or nose and into the lungs to restore breathing.
If the swelling blocks the airway, the patient needs to get emergency medical help right away.
This is done through an intervention called tracheotomy, where a small opening is created surgically directly into the windpipe through the neck
The surgery called a tracheostomy creates an opening through the neck into the windpipe.
In some patients, a tube is inserted through the nose into the lungs for maintaining the airway.
Antibiotic medicines are advised for treatment of the underlying bacterial infection.
The selection of antibiotic should be broad spectrum and fight against anaerobic, gram-negative and gram positive organisms.
The combined usage of penicillin, metronidazole and clindamycin is given until an appropriate antibiotic is chosen after culture and sensitivity.
Surgery may be required to drain fluids that are producing the swelling.

TABLE OF CONTENT
Introduction
Chapter 1 Ludwig’s Angina
Chapt

• Language: English
• Publisher: Kenneth Kee
• Release date: May 25, 2017
• ISBN: 9781370060634

Kenneth Kee

Medical doctor since 1972.Started Kee Clinic in 1974 at 15 Holland Dr #03-102, relocated to 36 Holland Dr #01-10 in 2009.Did my M.Sc (Health Management ) in 1991 and Ph.D (Healthcare Administration) in 1993.Dr Kenneth Kee is still working as a family doctor at the age of 74However he has reduced his consultation hours to 3 hours in the morning and 2 hours inthe afternoon.He first started writing free blogs on medical disorders seen in the clinic in 2007 on http://kennethkee.blogspot.com.His purpose in writing these simple guides was for the health education of his patients which is also his dissertation for his Ph.D (Healthcare Administration). He then wrote an autobiography account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.comThis autobiography account “A Family Doctor’s Tale” was combined with his early “A Simple Guide to Medical Disorders” into a new Wordpress Blog “A Family Doctor’s Tale” on http://ken-med.com.From which many free articles from the blog was taken and put together into 1000 eBooks.He apologized for typos and spelling mistakes in his earlier books.He will endeavor to improve the writing in futures.Some people have complained that the simple guides are too simple.For their information they are made simple in order to educate the patients.The later books go into more details of medical disorders.He has published 1000 eBooks on various subjects on health, 1 autobiography of his medical journey, another on the autobiography of a Cancer survivor, 2 children stories and one how to study for his nephew and grand-daughter.The purpose of these simple guides is to educate patient on health disorders and not meant as textbooks.He does not do any night duty since 2000 ever since Dr Tan had his second stroke.His clinic is now relocated to the Buona Vista Community Centre.The 2 units of his original clinic are being demolished to make way for a new Shopping Mall.He is now doing some blogging and internet surfing (bulletin boards since the 1980's) startingwith the Apple computer and going to PC.The entire PC is upgraded by himself from XT to the present Pentium duo core.The present Intel i7 CPU is out of reach at the moment because the CPU is still expensive.He is also into DIY changing his own toilet cistern and other electric appliance.His hunger for knowledge has not abated and he is a lifelong learner.The children have all grown up and there are 2 grandchildren who are even more technically advanced than the grandfather where mobile phones are concerned.This book is taken from some of the many articles in his blog (now with 740 posts) A Family Doctor’s Tale.Dr Kee is the author of:"A Family Doctor's Tale""Life Lessons Learned From The Study And Practice Of Medicine""Case Notes From A Family Doctor"

Book preview

Ludwig’s Angina,

A

Simple

Guide

To

The Condition,

Diagnosis,

Treatment

And

Related Conditions

By

Dr Kenneth Kee

M.B.,B.S. (Singapore)

Ph.D (Healthcare Administration)

Copyright Kenneth Kee 2017 Smashwords Edition

Published by Kenneth Kee at Smashwords.com

Dedication

This book is dedicated

To my wife Dorothy

And my children

Carolyn, Grace

And Kelvin

This book describes Ludwig’s Angina, Diagnosis and Treatment and Related Diseases which is seen in some of my patients in my Family Clinic.

(What The patient Need to Treat Ludwig’s Angina)

This eBook is licensed for your personal enjoyment only. This eBook may not be re-sold or given away to other people. If the patient would like to share this book with another person, please purchase an additional copy for each reader.

If you’re reading this book and did not purchase it, or it was not purchased for your use only, then please return to Smashwords.com and purchase your own copy.

Thank the patient for respecting the hard work of this author.

Introduction

I have been writing medical articles for my blog http://kennethkee.blogspot.com (A Simple Guide to Medical Disorder) for the benefit of my patients since 2007.

My purpose in writing these simple guides was for the health education of my patients.

Health Education was also my dissertation for my Ph.D (Healthcare Administration).

I then wrote an autobiolographical account of his journey as a medical student to family doctor on his other blog http://afamilydoctorstale.blogspot.com.

This autobiolographical account A Family Doctor’s Tale was combined with my early A Simple Guide to Medical Disorders into a new Wordpress Blog A Family Doctor’s Tale on http://kenkee481.wordpress.com.

From which many free articles from the blog was taken and put together into 800 amazon kindle books and 200 into Smashwords.com eBooks.

Some people have complained that the simple guides are too simple.

For their information they are made simple in order to educate the patients.

The later books go into more details of medical disorders.

The first chapter is always from my earlier blogs which unfortunately tends to have typos and spelling mistakes.

Since 2013, I have tried to improve my spelling and writing.

As I tried to bring the patient the latest information about a disorder or illness by reading the latest journals both online and offline, I find that I am learning more and improving on my own medical knowledge in diagnosis and treatment for my patients.

Just by writing all these simple guides I find that I have learned a lot from your reviews (good or bad), criticism and advice.

I am sorry for the repetitions in these simple guides as the second chapters onwards have new information as compared to my first chapter taken from my blog.

I also find repetition definitely help me and maybe some readers to remember the facts in the