ENT
LUDWIG'S ANGINA
Prompt
ResponseErythema under mandible, extending to anterior chest wall.
Swelling below mandible on R side
Kard swelling R side of face and below mandible/neck
Ludwig angina is life-threatening cellulitis of the soft tissue involving the floor of the mouth and neck. Ludwig angina involves 3 compartments of the floor of the mouth: sublingual, submental, and submandibular. The infection is rapidly progressive, leading to potential airway obstruction.
Swelling below mandible on R side
Kard swelling R side of face and below mandible/neck
Ludwig angina is life-threatening cellulitis of the soft tissue involving the floor of the mouth and neck. Ludwig angina involves 3 compartments of the floor of the mouth: sublingual, submental, and submandibular. The infection is rapidly progressive, leading to potential airway obstruction.
PromptManagement of ludwig's angina
ResponseAnalgesia - Morphine 2.5mg + repeat
IV ABx - Ampicillin 1g + metronidazole 500 mg (eTG = IV augmentin, Clinda if penicillin hypersensitivity)
IV fluids - N/S Bolus aim HR <100, MAP >65
Airway management - Awake fibreoptic intubation in theatres
Imaging - CT neck/chest ? abscess
ENT referral for surgical drainage of abscess
IV ABx - Ampicillin 1g + metronidazole 500 mg (eTG = IV augmentin, Clinda if penicillin hypersensitivity)
IV fluids - N/S Bolus aim HR <100, MAP >65
Airway management - Awake fibreoptic intubation in theatres
Imaging - CT neck/chest ? abscess
ENT referral for surgical drainage of abscess