Relato de caso clínico de infecção odontogênica resultando em complicação cervicofacial / Reporte de caso clínico de infección odontogênica com resultado de complicación cervicofacial / Clinical case reportof odontogenic infectionresulting cervicofacial complication

Introdução: A saúde bucal é um aspecto que não deve ser subestimado pelos pacientes, principalmente se considerar que as infecções odontogênicas podem levar a quadros graves, incluindo complicações cervicotorácicas, como Mediastinite e cervicofaciais, como Angina de Ludwig. Para tanto, é imprescindível que os profissionais da odontologia saibam reconhecer os principais sinais e sintomas dessas infecções, sua evolução, conhecer as complicações associadas e qual o manejo adequado. Objetivo: Assim, é objetivo deste trabalho, relatar, discutir um caso clínico de uma infecção odontogênica grave que acarretou em complicação cervical, com trajeto em direção ao mediastino, necessitando manejo multidisciplinar, e explorar os principais aspectos desse quadro e a conduta necessária, que exige, no mínimo, intervenção cirúrgica, antibioticoterapia e manutenção das vias aéreas. Relato de caso: O caso trata de um paciente com infecção odontogênica, iniciada como uma pericoronarite do dente 38 semieruptado, que evoluiu para a área cervical, demandando imediata drenagem nesta região pois encaminhava-se para uma mediastinite. Após a drenagem cervical e antibioticoterapia e, assim que houve redução do trismo, foi removido o dente 38, evoluindo para a cura.Conclusões:As infecções odontogênicas, principalmente as que acometem os espaços fasciais e cervicais profundos, são potencialmente graves e devem ter suas principais manifestações clínicas entre os domínios de conhecimento dos profissionais Bucomaxilofaciais, pois necessitam de diagnóstico preciso, manejo rápido e tratamento adequado e precoce, considerando a velocidade com que podem evoluir (AU).

Introduction: Oral healthis an aspect that should not be underestimated by patients, especially considering that dental infections can lead to serious symptoms, including cervicothoracic complications, such as Mediastinitis and cervicofacial complications, such as Ludwig's Angina. Therefore, it is essential that dental professionals know how to recognize the main signs and symptoms of these infections, their evolution, know the associated complications and appropriate management.Objective: Thus, this work aims to report and discuss a clinical case of a serious odontogenic infection that resulted in a cervical complication, with a path towards the mediastinum, requiring multidisciplinary management, and to explore the main aspects of this condition and the necessary conduct, which requires, at least, surgical intervention, antibiotic therapy and airway maintenance.Case report: The case concerns a patient with odontogenic infection, which began as pericoronitis of semi-erupted tooth 38, which progressed to the cervical area, requiring immediate drainage in this region as it was heading towards mediastinitis. After cervical drainage and antibiotic therapy and, as soon as the trismus was reduced, tooth 38 was removed, progressing towards healing.Conclusions: Odontogenic infections, especially those that affect the fascial and deep cervical spaces, are potentially serious and should have their main clinical manifestations among the domains of knowledge ofOral and Maxillofacial professionals, as they require accurate diagnosis, rapid management and adequate and early treatment, considering the speed at which they can evolve (AU).

Introducción: La salud bucal es un aspecto que los pacientes no deben subestimar, especialmente considerando que las infecciones odontógenas pueden derivar en afecciones graves, incluidas complicaciones cervicotorácicas, como la mediastinitis, y complicaciones cervicofaciales, como la angina de Ludwig.Para ello, es fundamental que los profesionales odontológicos sepan reconocer las principales señalesy síntomas de estas infecciones, su evolución, conocer las complicaciones asociadas y el manejo adecuado.Objetivo: Así,el objetivo de este trabajo es reportar y discutir un caso clínico de infección odontogénica grave que resultó en una complicación cervical, con trayecto hacia el mediastino, que requirió manejo multidisciplinario, y explorar los principales aspectos de esta condicióny las medidas necesarias, que requiere, como mínimo, intervención quirúrgica, terapia con antibióticos y mantenimiento de las vías respiratorias.Reporte de caso: El caso se trata de un paciente con una infección odontogénica, que comenzó como pericoronaritis del diente 38 semi-erupcionado, la cual progresó hacia la zona cervical, requiriendo drenaje inmediato en esta región ya que se encaminaba para una mediastinitis.Después del drenaje cervical y la terapia antibiótica y, una vez reducido el trismo, se extrajo el diente 38, evolucijjonando hacia la cura.Conclusiones: Las infecciones odontogénicas, especialmente aquellas que afectan los espacios fasciales y cervicales profundos, son potencialmente graves y deben tener sus principales manifestaciones clínicas entre los dominios del conocimiento de los profesionales Orales y Maxilofaciales, pues requieren de un diagnóstico certero, un manejo rápido y un tratamiento adecuado y temprano, considerando la velocidad a la que pueden evolucionar (AU).

Video-stylet vs. channeled hyperangulated videolaryngoscope: Efficacy in simulated Ludwig's angina randomized cadaver trial.

INTRODUCTION: Ludwig's angina (LA) is a life-threatening infection that can affect the floor of the mouth and neck, potentially causing serious airway obstruction. In such cases, rescue airway management and oxygenation can be challenging due to swelling of the mouth floor, trismus, and limited mouth opening. The aim of this study was to assess the efficacy of the Trachway video-stylet (VS) and Pentax AWS hyperangulated videolaryngoscope with channel (HAVL-C) compared to the standard geometric video-laryngoscope (SGVL, Macintosh 3, Trachway) in simulating Ludwig's angina with cadavers. METHODS: Three fresh frozen cadavers were prepared with varying degrees of difficulty to simulate the airway conditions of patients with LA, including mouth floor swelling, restricted mouth opening, and trismus. Fifty-five second-year resident physicians from various specialties participated in the study and received training in airway management using SGVL, VS, and HAVL-C devices. Participants were randomly assigned to intubate simulated LA with cadavers using the three devices in a random order, and intubation times and success rates were recorded. Participants also rated the difficulty of intubation using a visual analogue scale (VAS) score. The primary outcome assessed the first-pass intubation success or failure, while the secondary outcomes measured the intubation time and subjective difficulty using a visual analogue scale with different laryngoscopes. RESULTS: The success rates for intubation within 90 s were 40% for SGVL, 82% for VS, and 76% for HAVL-C. VS and HAVL-C had significantly higher success rates than SGVL, with hazard ratios of 3.4 and 2.7, and 95% confidence intervals (CI) of 2.0-5.7 and 1.6-4.6, p < 0.001, respectively. The odds ratios of successful intubation for VS and HAVL-C were 8.1 and 6.3, respectively, with a 95% CI of 3.7-17.8 and 2.4-16.7, p < 0.001, compared to SGVL. The VAS score was significantly correlated with intubation success rate and time. CONCLUSIONS: In cases of LA, the use of VS and HAVL-C is preferable over SGVL. These findings suggest that using VS and HAVL-C can improve intubation success rates and reduce intubation time in patients with LA.

Estudo transversal retrospectivo das infecções odontogênicas em um hospital universitário público / Retrospective cross-sectional study of dental infections in a public university hospital

Infecções odontogênicas são quadros clínicos que podem se agravar quando não tratados no tempo e da forma adequada. A disseminação do processo infeccioso para os tecidos e espaços fasciais adjacentes leva a internação hospitalar e pode provocar com frequência grande morbidade, mas raramente óbitos. Propusemo-nos a analisar por um estudo retrospectivo dados de prontuários de pacientes com infecções odontogênicas no período de janeiro de 2010 a janeiro de 2021 em um hospital universitário público para verificar possíveis associações de fatores clínicos e laboratoriais no aumento do tempo de internação. Uma amostra aleatória de 220 prontuários conforme a Classificação Internacional de Doenças (CID-10) em K-047 (abscesso periapical) e K-122 (celulite e abscesso da boca) foi selecionada para coleta de dados. 43% dos prontuários (n=99) continham a maioria das informações para coleta das variáveis como: sexo, idade, regiões anatômicas envolvidas, comorbidades, resultados de exames laboratoriais quando presentes (contagem de leucócitos, proteína C-reativa e hemoglobina), origem da infecção, tratamento, período de internação, antibióticos administrados, relato ou outras medicações quando descritas. Os dados foram distribuídos quanto a média e desvio padrão, medidas de frequência e foram submetidos a teste de associação (qui-quadrado ou exato de Fisher) para algumas variáveis relacionadas a gravidade e alongamento do tempo de hospitalização. A maioria dos casos foi de celulite e abscessos da boca (K-122)sendo os mais graves em homens com idade entre os 27 a 32 anos. Não foramreportados óbitos. Os casos de menor gravidade foram abscesso periapical (K-047) envolveram igualmente homens e mulheres na sua maioria crianças entre 12 e 13 anos. A região mais acometida em toda a amostra foi o espaço submandibular. Houve evolução para mediastinite em cinco casos e em 14 para angina de Ludwig. O período de internação para os casos de menor gravidade foi de 3 dias em média enquanto para os casos de maior gravidade ultrapassaram 7 dias. Encontramos associação significativa na amostra total vinculando alongamento da permanência hospitalar por mais do que 3 dias (72h) com os casos de maior gravidade incluindo 6 os registros de celulite e abscesso da boca (K-122), (p=0.003) e quando múltiplos espaços estivessem acometidos (p<0.001). Não foi possível verificar associação significativa entre os resultados dos exames laboratoriais e o alongamento da permanência hospitalar (>72h) porém nos casos de maior gravidade os níveis de PCR se confirmaram significativamente mais elevados. Para os de menor gravidade, periapical (K-047), a penicilina e derivados foram os antibióticos de escolha. Para os casos de maior gravidade a associação de ceftriaxona e clindamicina foi a mais utilizada. Concluímos que os dados corroboram com os dados da literatura internacional. Um estudo prospectivo com maior amostra deve ser conduzido para sugerir fatores preditores clínicos e laboratoriais de gravidade e alongamento de permanência hospitalar.

Ludwig's Angina: Higher Incidence and Worse Outcomes Associated With the Onset of the Coronavirus Disease 2019 Pandemic.

Background: Ludwig's angina (LA) is a diffuse cellulitis of the submandibular space and adjacent tissues. During the coronavirus disease 2019 (COVID-19) pandemic, odontogenic treatments were often delayed because of the implementation of safety measures to avoid the spread of the virus. We hypothesized that delayed odontogenic treatments associated with the onset of the COVID-19 pandemic would be associated with an increase in the incidence of LA and worse outcomes related to these infections. Patients and Methods: Patients from June 2018 to June 2022 with computed tomography images suggestive of LA and confirmed by ear, nose, throat (ENT) consult were included. We abstracted demographics, outcomes, clinical management, and microbiology. Patients were stratified into pre-COVID and COVID-onset. Our primary outcome, incidence of LA, was defined as: (new LA cases) ÷ (ED evaluations of oral or dental infections × 1.5 years). Results: In the pre-COVID group, we identified 32 of 1,301 patients with LA for an incidence of 0.02 per year. The COVID-onset group consisted of 41 of 641 patients, with an incidence of 0.04 per year. In the COVID-onset group, progression to necrotizing fasciitis was more likely (0% vs. 15%; p < 0.024), and they returned to the operating room for repeated debridement (3% vs. 22%; p < 0.020). Likewise, hospital length of stay, intensive care unit (ICU) length of stay, and ventilator days were higher (4.3 ± 3.5 vs. 9.5 ± 11.3; 1.1 ± 1.2 vs. 9.5 ± 7.1; 0.3 ± 1 vs. 3.6 ± 7.1; p < 0.001). Conclusions: Although the prognosis for dental infections diagnosed early is generally favorable, we observed a notable increase in the incidence of LA after the onset of the COVID-19 pandemic. Moreover, complications stemming from these infections became more severe in the COVID-onset era. Specifically, the likelihood of necrotizing fasciitis showed a substantial increase, accompanied by an increased risk of respiratory failure and mediastinitis.

Unusual Case of Ludwig Angina Caused by Clostridium sporogenes in an Immunocompromised HIV-Positive Patient with Alcoholism and Dental Abscess.

BACKGROUND Ludwig angina is a cellulitis of the soft tissues of the neck and floor of the mouth. It is most commonly caused by Viridans streptococcal species, but other bacterial species have been shown to lead to this severe infection. Clostridium sporogenes is an anaerobic gram-positive, spore-producing bacillus found in soil and the human gastrointestinal tract. This report is of a case of a 49-year-old HIV-positive man with alcoholism and poor dental hygiene leading to a molar abscess who presented with Ludwig angina due to C. sporogenes. CASE REPORT A 49-year-old man presented with severe left molar pain, fever, and worsening neck swelling for 5 days. His medical history was significant for AIDS; he was not on antiretroviral therapy. Computed tomography of the neck was positive for extensive subcutaneous emphysema of the left sublingual space. Ludwig angina was diagnosed, and he was taken urgently for incision and drainage of the bilateral neck fascial space. On day 6 of hospitalization, 1 of 2 blood cultures grew C. sporogenes. He left the hospital on day 13 and was readmitted 6 days later with progression of the disease and alcohol withdrawal. CONCLUSIONS This case illustrates the need for rapid diagnosis and treatment of Ludwig angina and the importance of considering commonly pathogenic and rarely pathogenic bacteria when considering the underlying bacterial cause of an infection in an immunocompromised patient. To the best of our knowledge, this is the first case of Ludwig angina caused by C. sporogenes reported in the medical literature.

Ludwig's angina, anterior neck abscess and cavernous venous thrombosis following third molar extraction.

Ludwig's angina (LA) is a rapidly progressing cellulitis that develops after oral infections or molar extractions, typically causing fever and chills and rarely progressing to trismus and cyanosis. It is associated with risk factors including diabetes mellitus, heavy alcohol use, oral malignancy, poor dentition or an immunocompromised state. This case report reviews a previously healthy patient with no appreciable risk factors presenting with LA following a third molar extraction, complicated by extensive anterior deep neck space abscesses, cavernous venous thrombosis and Lemierre's Syndrome. Our case demonstrates the importance of early intervention when suspecting LA to prevent life-threatening complications and death.

Trends and Outcome of Aggressive Fascial Space Infections.

Background: Odontogenic infections are common and self-limiting in most cases; however, they can lead to severe consequences, considerable morbidity and can even be fatal despite modern medical therapy. Patients and Methods: This retrospective study included patients with severe deep fascial space infections treated in the Maxillofacial Surgery Unit, General Surgery Department, Faculty of Medicine, Sohag University, Sohag Governorate, Egypt, and the Department of Oral and Maxillofacial Surgery, King Fahd Specialist Hospital (tertiary referral center), Burayda City, Qassim Province, Saudi Arabia, from June 2017 to June 2022. Results: This study included 296 patients, 161 (54.4%) males, 135 (45.6%) females. The fifth decade of life was the most common vulnerable age group. Forty-three percent of patients had diabetes mellitus, 26.6% were hypertensive, and 13.3% were on long-term steroid therapy. In 83% of patients, the offending tooth was identified but in 17% of patients no dental cause was identified. The lower third molar tooth was most commonly involved. Sixty-nine (23.3%) patients had submandibular space infections. Fifty-three (17.9%) patients had canine space infections. Thirty (10.1%) patients had submasseteric space infection. Twenty-eight (9.5%) patients had submental space infections. Twenty-three (7.8%) patients had combined infection of the submasseteric, submandibular, and pterygomandibular spaces, whereas 19 (6.4%) patients presented with Ludwig's angina. Conclusions: Odontogenic infections are common. The submandibular space is the most commonly affected single space. These infections could lead to lethal complications in immunocompromised patients, especially patients with diabetes mellitus. These infections require urgent surgical intervention to decrease hospital stays and avoid potentially lethal complications.

Adolescent Patient with Cystic Fibrosis Presents with Suspected Ludwig Angina.

A 15-year-old boy attended Emergency Department with a complaint of difficulty in breathing due to dental infection. A pulmonologist was consulted regarding the severity of the cystic fibrosis. The patient was admitted and intravenous (IV) fluids and antibiotics were given. The infected mandibular right first permanent molar tooth # 30 was extracted under IV ketamine dissociative anesthesia in the hospital setting.

The empirical use of aminoglycosides in Ludwig's angina based on bacterial analysis of 63 cases.

PURPOSES: To determine if the empirical use of aminoglycosides is justified in Ludwig's angina based on microscopy, culture and sensitivity results. METHODS: A retrospective analysis was done on patients that presented with Ludwig's angina to the Maxillofacial and Oral surgery department at the University of Pretoria. Demographical data was extracted from patient files. Pus specimens that were submitted as part of the initial surgical intervention were analysed. RESULTS: Sixty-three patients were included in the study with the majority, 76.19% (n=48/63), comprising males. The mean patient age was 38.6 years (range 6 months to 78 years). The majority of infections (87.3%) had an odontogenic aetiology (n=55/63). Forty-four percent of the patients had immunosuppressive co-morbidities (n=28/63). Streptococci contributed 71.26% (n=62/87) of the cultured bacteria. Similar bacteria were cultured in the immunocompromised and the immunocompetent patients (p=0.672). Ninety-two percent (n=57/62) of the streptococci cultured were sensitive to penicillin. The addition of aminoglycosides to the study sample would not have made a statistically significant difference (p=0.1556). CONCLUSION: Based on the findings of this study, the empirical use of aminoglycosides is not warranted in either immunocompromised or immunocompetent patients with Ludwig's angina.

Facial Swelling After Dental Work Done: A Case of Ludwig's Angina.

Ludwig's angina is a fast-spreading cellulitis located on the floor of the oropharynx and neck (Tami, Othman, Sudhakar, & McKinnon, 2020). Patients may present with a wide range of symptoms depending on the severity of the condition (Reynolds & Chow, 2007). Emergency nurse practitioners need to promptly identify, diagnose, and treat patients with this problem, with close attention to the patient's airway. A compromised airway is the leading cause of mortality from this condition (McDonnough et al., 2019). The diagnosis is generally made with a comprehensive history and physical examination, laboratory values, and imaging studies such as computer tomography (Bridwell, Gottlieb, Koyfman, & Long, 2021). Management includes admission to the hospital, broad-spectrum antibiotics, and specialist surgical consultation (Bridwell et al., 2021).

Ludwig's Angina.

Ludwig's angina is a severe diffuse cellulitis that presents an acute onset and spreads rapidly and bilaterally. It can affect the submandibular, sublingual or submental spaces resulting in a state of emergency. Early diagnosis and urgent management could be a life-saving procedure. We report a case of wide spread sialadenitis infection extending to the neck with trismus and elevation of the floor of the mouth that caused an obstruction of the airway and resulted in an inspiratory dyspnea and a stridor. The patient was directed to maintain the airway by elective tracheostomy. An appropriate use of parenteral antibiotics, airway protection techniques, and potential surgical drainage of the infection remain the standard protocol of treatment in advanced cases of Ludwig's angina. The aim of this case report is to emphasize on the importance of early diagnosis and appropriate management of Ludwig's angina.

Extrapulmonary tuberculosis and COVID-19 infection coexisting in concurrent necrotising fasciitis with deep space infection of neck: an unusual presentation.

Ludwig's angina is a rapidly spreading, potentially fatal infection of deep fascial spaces of the neck leading to airway oedema and death. This, in recent times when associated with COVID-19 infection, possess treatment challenges making the patient susceptible to opportunistic infections with reduced healing potential. Owing to the multifactorial aetiology in our case and addressing them at the earliest, it is important to achieve favourable outcomes. The space infection that seeded with untreated trivial dental caries progressed to necrotising fasciitis of neck with mycobacterial growth on cartridge-based nucleic acid amplification test for tuberculosis testing. The presence of Mycobacterium organisms should be speculated in patients with pulmonary signs of tuberculosis (TB) because a suppurative TB lymphadenitis of neck could also have the same presentation. The decisive moment in successful outcome was identification of mycobacteria in COVID-19 infected patient, thereby allowing to initiate the antitubercular therapy along with surgical debridement. Thus, medical management of patient with cohabiting infections is difficult task and needs appropriate addressal.

Complications of dental infections due to diagnostic delay during COVID-19 pandemic.

We present three cases who presented to the emergency department with severe complications of dental infections: Ludwig's angina, necrotising fasciitis and peritonsillar abscess. All of our cases presented at the beginning of COVID-19 pandemic, with complications of dental infections. They delayed their dental treatment due to the pandemic. The airway management was difficult in our cases. Their mortality risk increased due to complications. We aimed to draw attention to complicated odontogenic infections which are rarely seen in emergency department in the past, however started to show up increasingly particularly at the beginning of the COVID-19 pandemic.

Ketamine-Induced Spontaneous Breathing Intubation With Airway Topicalization: A Case Report of Airway Obstruction in Retrieval Care.

A LifeFlight Retrieval Medicine air medical team was tasked to a rural facility 200 km away to manage and retrieve a 73-year-old woman with evolving airway obstruction. Resources at the referring site included a general practitioner with anesthetic skills training but no access to otorhinolaryngology (ear, nose, and throat) or flexible fiberoptic airway devices. On arrival of the LifeFlight Retrieval Medicine, the patient became agitated, with deterioration in her airway patency. A clinical diagnosis of Ludwig's angina with evolving airway obstruction was made. Using a technique of ketamine-facilitated, spontaneous breathing tracheal intubation with a video laryngoscope, the retrieval team was able to safely secure the patient's airway before transporting her to a regional hospital with ear, nose, and throat surgical services. Computed tomographic imaging revealed an oropharyngeal abscess with spread into the larynx, which subsequently underwent surgical drainage. This case report outlines the technique of awake laryngoscopy with relevance to the retrieval physician and discusses some of the challenges and potential complications associated with it.

Análise de prontuários de pacientes com infecções odontogênicas atendidos no serviço hospitalar / Análisis de registros de pacientes con infecciones dentales atendidos en el servicio de hospital / Analysis of records of patients with dental infections care at the hospital service

Objetivo: O seguinte estudo é uma análise de prontuários para traçar um perfil epidemiológico de pacientes acometidos por infecções odontogênicas e/ou angina de Ludwig em um serviço hospitalar público. Metodologia: Foi realizado um estudo observacional de 37 prontuários com diagnóstico de infecção odontogênica e/ou Angina de Ludwig no Hospital da Restauração, na cidade do Recife, Pernambuco, entre os meses de julho a novembro de 2021. Resultados: Dos 37 prontuários, a maioria foi do sexo masculino (55%; n=20), a faixa etária mais acometida foi dos 18 aos 40 (45%; n=17); abaixo dos 10 anos foram acometidos 27% (n = 10). 21% (n = 8) foram internados e dos 37 prontuários, 13% (n = 5) evoluíram para Angina de Ludwig. Conclusão: O perfil mais acometido por infecções odontogênicas no período proposto foram pacientes do sexo masculino adultos e a internação não prevaleceu na maioria dos casos. O alto acometimento de crianças é um sinal de alerta, sugerindo uma atenção maior dos responsáveis. A angina de Ludwig acometeu menos da metade dos pacientes e a Ceftriaxona e o Metronidazol foram os antibióticos de escolha para a maioria dos casos... (AU)

Objetivo: El siguiente estudio es un análisis de historias clínicas para trazar un perfil epidemiológico de los pacientes afectados por infecciones odontogénicas y/o angina de Ludwig en un servicio hospitalario público. Metodología: Se realizó un estudio observacional en 37 historias clínicas con diagnóstico de infección odontogénica y/o Angina de Ludwig en el Hospital da Restauração, en la ciudad de Recife, Pernambuco, entre julio y noviembre de 2021. Resultados: De las 37 historias clínicas, la mayoría eran hombres (55%; n=20), el grupo de edad más afectado fue el de 18 a 40 años (45%; n=17); menores de 10 años, el 27% (n = 10) estaban afectados. El 21% (n = 8) fueron hospitalizados y de las 37 historias clínicas, el 13% (n = 5) progresó a Angina de Ludwig. Conclusión: El perfil más afectado por infecciones odontogénicas en el periodo propuesto fueron pacientes adultos del sexo masculino y no predominó la hospitalización en la mayoría de los casos. La alta participación de los niños es una señal de advertencia, lo que sugiere una mayor atención por parte de los responsables. La angina de Ludwig afectó a menos de la mitad de los pacientes y la ceftriaxona y el metronidazol fueron los antibióticos de elección en la mayoría de los casos... (AU)

Objective: The following study is an analysis of medical records to trace an epidemiological profile of patients affected by odontogenic infections and/or Ludwig's angina in a public hospital service. Methodology: An observational study was carried out on 37 medical records with a diagnosis of odontogenic infection and/or Ludwig's Angina at Hospital da Restauração, in the city of Recife, Pernambuco, between July and November 2021. Results: Of the 37 medical records, the most were male (55%; n=20), the age group most affected was from 18 to 40 (45%; n=17); under 10 years of age, 27% (n = 10) were affected. 21% (n = 8) were hospitalized and of the 37 medical records, 13% (n = 5) progressed to Ludwig's Angina. Conclusion: The profile most affected by odontogenic infections in the proposed period were adult male patients and hospitalization did not prevail in most cases. The high involvement of children is a warning sign, suggesting greater attention from those responsible. Ludwig's angina affected less than half of the patients and Ceftriaxone and Metronidazole were the antibiotics of choice for most cases... (AU)