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1.
Ann R Coll Surg Engl ; 101(7): e150-e153, 2019 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-31232606

RESUMEN

Abscess of the anterior belly of the digastric muscle has not been previously described and could pose a diagnostic and interventional dilemma. This case summarises the clinical, microbiological, radiological and surgical issues encountered and suggests learning points for clinicians posed with similar presentations. We recommend timely assessment by an appropriately trained clinician in either ear, nose and throat or oral and maxillofacial surgery, admission to a closely observable environment with airway-trained nursing staff and with potential for escalation to high dependency or intensive care in the event of airway compromise, as well as early involvement of an anaesthetist. Multimodality imaging should be performed to identify and localise an abscess collection or phlegmon, including an orthopantomogram in anticipation of odontogenic source and dental extraction as a definitive intervention. Surgical intervention for the abscess collection should be considered with consideration of the important neurovascular structures in this region.


Asunto(s)
Absceso/diagnóstico , Músculos del Cuello/diagnóstico por imagen , Absceso/complicaciones , Absceso/terapia , Administración Intravenosa , Antibacterianos/administración & dosificación , Celulitis (Flemón)/etiología , Trastornos de Deglución/etiología , Diagnóstico Diferencial , Humanos , Angina de Ludwig/diagnóstico , Masculino , Persona de Mediana Edad , Dolor de Cuello/etiología , Paracentesis , Tomografía Computarizada por Rayos X , Resultado del Tratamiento
2.
Br J Nurs ; 28(9): 547-551, 2019 May 09.
Artículo en Inglés | MEDLINE | ID: mdl-31070977

RESUMEN

Although relatively uncommon, Ludwig's angina is a potentially life-threatening infection of the floor of the mouth and neck. There is a danger of airway obstruction by swelling in the area and displacement of the tongue, and patients are at risk of deterioration. There are many factors thought to place patients at an increased risk of developing the condition. These include recent dental treatment, dental caries or generally poor dentition, chronic disease such as diabetes, alcoholism and malnutrition, and patients with compromised immune systems (eg AIDS, organ transplantation). This article examines the aetiology of Ludwig's angina and considers the presentation, diagnosis and treatment of a patient who presented to an out-of-hours streaming area of a local emergency department, with an emphasis on the importance of a multidisciplinary approach. It also considers the need for ongoing education and awareness of health professionals to ensure the successful diagnosis, management and treatment of this condition, particularly in the context of patients with poor access to dental care presenting first to the emergency department.


Asunto(s)
Angina de Ludwig/diagnóstico , Angina de Ludwig/terapia , Grupo de Atención al Paciente , Atención Posterior , Atención Odontológica , Servicio de Urgencia en Hospital , Accesibilidad a los Servicios de Salud , Humanos , Angina de Ludwig/etiología , Masculino , Persona de Mediana Edad
3.
J Endod ; 45(1): 79-82, 2019 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-30446404

RESUMEN

Ludwig angina is a life-threatening type of soft tissue cellulitis involving 3 compartments on the floor of the mouth including the submental, sublingual, and submandibular spaces bilaterally. Prevention, early recognition, and treatment of Ludwig angina are critical because this is a clinical diagnosis with unpredictable progression. This article describes a rare case of Ludwig angina that evolved from an odontogenic infection and the specific microbiology and clinical course and discusses possible etiologies and prevention.


Asunto(s)
Atención Odontológica/efectos adversos , Necrosis de la Pulpa Dental/complicaciones , Primeros Auxilios/efectos adversos , Angina de Ludwig/etiología , Angina de Ludwig/terapia , Absceso Periapical/complicaciones , Enfermedad Aguda , Combinación Amoxicilina-Clavulanato de Potasio/administración & dosificación , Antibacterianos/administración & dosificación , Desbridamiento , Necrosis de la Pulpa Dental/terapia , Diagnóstico Precoz , Humanos , Angina de Ludwig/diagnóstico , Angina de Ludwig/prevención & control , Masculino , Absceso Periapical/terapia , Radiografía Dental , Tratamiento del Conducto Radicular , Tomografía Computarizada por Rayos X , Traqueostomía , Resultado del Tratamiento , Adulto Joven
4.
Emerg Med Clin North Am ; 37(1): 95-107, 2019 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-30454783

RESUMEN

Infection of the neck is a relatively common emergency department complaint. If not diagnosed and managed promptly, it may quickly progress to a life-threatening infection. These infections can result in true airway emergencies that may require fiberoptic or surgical airways. This article covers common, as well as rare but emergent, presentations and uses an evidence-based approach to discuss diagnostic and treatment modalities.


Asunto(s)
/diagnóstico , Cuello , Urgencias Médicas , Epiglotitis/diagnóstico , Epiglotitis/terapia , Humanos , Síndrome de Lemierre/diagnóstico , Síndrome de Lemierre/terapia , Angina de Ludwig/diagnóstico , Angina de Ludwig/terapia , Mediastinitis/diagnóstico , Mediastinitis/terapia , Parotiditis/diagnóstico , Parotiditis/terapia , Absceso Peritonsilar/diagnóstico , Absceso Peritonsilar/terapia , Faringitis/diagnóstico , Faringitis/terapia , Absceso Retrofaríngeo/diagnóstico , Absceso Retrofaríngeo/terapia
6.
Surg Radiol Anat ; 40(2): 221-225, 2018 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-28478605

RESUMEN

The mylohyoid (MH) musculature separates the sublingual and submandibular spaces and is, therefore, important with regard to the spread of infection and space occupying lesions. Moreover, the MH may be elevated and included in the myocutaneous submental island flap or sutured in conjunction with the platysmas and the anterior bellies of the digastric muscles (ABDMs) to add stability to submental muscular medialization procedures. Therefore, variation in the anatomy of the MH musculature must be considered in the management of the spread of infection and space occupying lesions as well as in surgical planning. This report reviews mylohyoid variations and documents a unique case in which several suprahyoid muscular variations occurred concurrently. The variations included isolated anterior bellies of the mylohyoid inserting into the geniohyoid thereby forming mylo-geniohyoid muscles as well as isolated posterior bellies of the mylohyoid inserting into the ABDM and the intermediate tendon of the digastric muscle thereby forming mylo-digastric muscles. Surgeons operating in the suprahyoid region should be aware of potential anatomical variation of the mylohyoid to develop contingency plans.


Asunto(s)
Músculos del Cuello/anatomía & histología , Anciano de 80 o más Años , Variación Anatómica , Cadáver , Disección , Humanos , Angina de Ludwig/diagnóstico , Angina de Ludwig/cirugía , Masculino
12.
Rev. medica electron ; 38(1)ene.-feb. 2016. ilus
Artículo en Español | CUMED | ID: cum-63492

RESUMEN

La angina de Ludwig es una enfermedad de causa infecciosa que afecta fundamentalmente al suelo de la boca. Se produce esencialmente por abscesos de segundo y tercer molar; tiene un comienzo insidioso, por lo que se debe pensar en ella, ya que de retrasarse el diagnóstico puede tener consecuencia fatales Las complicaciones más graves son la obstrucción de la vía aérea superior, edema de la glotis y mediastinitis descendente. Su tratamiento se basa en tres pilares esenciales, dados por medidas generales, tratamiento antibiótico y quirúrgico(AU)


Ludwigs angina is an infection-caused disease mainly affecting the floor of the mouth. It is essentially produced by second and third molar abscesses; it has an insidious beginning, so it has to be always taken into account because if it is diagnosed late, it may have fatal consequences. The most serious complications are the obstruction of the high air ways, glottis edema and descendant mediastinitis. The treatment is based in three essential supports, given by general measures, antibiotic and surgical treatment(AU)


Asunto(s)
Humanos , Femenino , Anciano , Angina de Ludwig/diagnóstico , Angina de Ludwig/tratamiento farmacológico , Infecciones de los Tejidos Blandos/diagnóstico , Infecciones de los Tejidos Blandos/tratamiento farmacológico , Informes de Casos
14.
A A Case Rep ; 6(4): 80-3, 2016 Feb 15.
Artículo en Inglés | MEDLINE | ID: mdl-26513672

RESUMEN

In this report, we describe the case of a young female with Down syndrome who presented to the anesthesia service after pulseless electrical activity arrest with a King LT(S)-D extraglottic airway device in situ. She had multiple predictors of difficult intubation, including what appeared to be a submental mass consistent with Ludwig's angina. She went on to receive an urgent tracheotomy because of those predictors but had full resolution of the submental mass on removal of the extraglottic airway device, which had been overinflated at the time of insertion. We outline the various techniques to establish a definitive airway with an extraglottic device in place.


Asunto(s)
Obstrucción de las Vías Aéreas/diagnóstico , Angina de Ludwig/diagnóstico , Errores Médicos/efectos adversos , Traqueotomía/efectos adversos , Adulto , Obstrucción de las Vías Aéreas/etiología , Obstrucción de las Vías Aéreas/cirugía , Diagnóstico Diferencial , Resultado Fatal , Femenino , Paro Cardíaco/terapia , Humanos
17.
Kulak Burun Bogaz Ihtis Derg ; 25(2): 102-8, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25935062

RESUMEN

OBJECTIVES: This retrospective study aims to detect the prognostic factors which affect the duration of hospital stay and evaluate the complications which develop in patients with deep neck infection. PATIENTS AND METHODS: The study included 77 patients (40 males, 37 females; mean age 42.4±20.1 years; range 11 to 88 years) treated with a diagnosis of deep neck infection in our clinic between November 2006 and November 2012. Patients' demographic and clinical features were analyzed to detect their associations with development of complications and hospitalization time. RESULTS: Odontogenic origin and submandibular localization were the most frequently observed clinical appearance. Of eight patients (10.4%) who developed serious complications, two (2.6%) died. Age, comorbidity, presence of anemia alone, Ludwig's angina and retropharyngeal involvement were associated with increased rate of complications (p<0.05); while sex, antibiotic usage prior to admittance and primary location of infection were not related (p>0.05). Submandibular localization and absence of leucopenia reduced the risk of complications (p<0.05). The mean duration of hospital stay was 12.9±8.7 days (range 2-59 days). Age, presence of comorbidity and development of complications extended the hospitalization period (p<0.05). CONCLUSION: In spite of the improvements in diagnosis and treatment, deep neck infection may be an important cause of mortality if complications develop. Comorbid anemia, Ludwig's angina and retropharyngeal involvement were identified as the strongest predictors in terms of development of complications. Duration of hospital stay extended in patients who developed complications.


Asunto(s)
Antibacterianos/uso terapéutico , Fascitis Necrotizante/etiología , Angina de Ludwig/diagnóstico , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Fascitis Necrotizante/diagnóstico , Fascitis Necrotizante/tratamiento farmacológico , Femenino , Estudios de Seguimiento , Humanos , Tiempo de Internación/tendencias , Angina de Ludwig/complicaciones , Angina de Ludwig/tratamiento farmacológico , Masculino , Persona de Mediana Edad , Cuello , Estudios Retrospectivos , Adulto Joven
19.
Indian J Med Microbiol ; 33(2): 300-2, 2015.
Artículo en Inglés | MEDLINE | ID: mdl-25865990

RESUMEN

Salmonella Typhi has rarely been associated with focal abscesses; and in literature, there is no evidence of its association with abscesses in the neck spaces. Ability of Salmonella Typhi to invade and localise in the neck spaces not only poses a diagnostic challenge but also underscores the necessity to understand the mechanisms that facilitate Salmonella Typhi to establish infections at sites completely non-traditional to the organism.


Asunto(s)
Angina de Ludwig/diagnóstico , Angina de Ludwig/patología , Salmonella typhi/aislamiento & purificación , Fiebre Tifoidea/diagnóstico , Fiebre Tifoidea/patología , Adulto , Humanos , Angina de Ludwig/microbiología , Masculino , Fiebre Tifoidea/microbiología
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