Saúde Bucal e Gestão Odontológica

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Ludwig's Angina in Pregnant Patient: A Case Report of Multi-Professional Treatment

Mohannad Al-Anezi, Hamada Mahran, Moayad Alomaym, Salma Albati, Majed Alharbi

Ludwig's Angina (LA) is cellulitis frequently originated from an odontogenic infection, classically related to the second or third lower molars, involving bilateral submandibular spaces. The typical symptomatology includes pain, dysphagia, trismus, tongue protrusion, and fever. In addition, there is an imminent risk of airway obstruction. The aim of the present study is to report a case of a 28-year-old patient with 30-weeks pregnancy hospitalized due to a volume increase in the bilateral region under the mandibular jaw. Blood exam depicted leukocytosis whilst panoramic X-Ray showed tooth 38 with caries and periapical lesion, highlighting it was the possible cause of Ludwig’s angina. Treatment was undertaken by a multi-professional team, a general surgeon to perform a tracheostomy and protect airways, an obstetrician to realize the child-birth due to the risk for the baby during general anesthesia, and a maxillofacial surgeon to extract tooth 38 and to drain submandibular area. During the entire treatment process, no complications occurred. The patient was followed up to 6 months and all complaints were overcome.