​Clinical Profile and Outcome of Ludwig’s Angina in Tertiary Care Hospital in Tamil Nadu

Background: Ludwig’s angina is a lethal infectious cellulitis of the submandibular space, which always makes a difficult situationfor treating surgeons.Objectives: The objective of this study was to study about the presentation, management, and clinical outcome of Ludwig’sangina.Materials and Methods: A study made in the Department of ENT - Head and Neck Surgery, Tirunelveli Medical College,Tirunelveli, for a period of 1 year from July 2016 to July 2017, a total of 41 patients - 33 males and 8 females were includedin the study.Results: Majority of the patients were having a dental infection before the episode - 85%. Pseudomonas aeruginosa is the mostcommon among the isolated pathogens. Six patients presented with stridor and needed tracheostomy. With early incision anddrainage, proper antibiotics and supportive measures, 37 patients survived without any morbidities. Despite all of our greatestefforts, four patients expired. Although comorbidities such as diabetes and chronic kidney disease are seen in few, majoritywere not having any other systemic illness.Conclusion: Prompt diagnosis and surgical drainage with broad-spectrum antibiotics and if needed tracheostomy often givemuch better results in the treatment of Ludwig’s angina. An early intervention of dental infection in early stages may be helpfulin avoiding progression into Ludwig’s angina.

Deep Neck Space Infection Along with Tuberculous Cervical Lymphadenitis in an HIV Patient / 대한이비인후과학회지

Recent literature indicates that the incidence of deep neck space infection is on the decline because of the availability of better antibiotics used for upper respiratory infection, but cases of deep neck space infection that do not respond to conventional antibiotic therapy are on the rise. This may be due to reduced immunity, debility, human immunodeficiency virus (HIV) infection, and improper or inadequate treatment. With the emergence of the HIV, the incidence of deep neck space infections and life threatening complications has been on the rise. We describe a case of tuberculous cervical lymphadenitis in an HIV infected patient who developed deep neck space infection and was treated by incision and drainage.

Clinical Study of Deep Neck Infection: Clinical Analysis of a Hundred Cases / 대한이비인후과학회지

BACKGROUND: Due to the antibiotic therapy and the appropriate treatment, the incidence of the infections of the neck decreased. But during last 5 years in the Red Cross hospital, there were the hundred cases. And a few significant complications were still experienced. OBJECTIVES: For the early treatment and the prevention of the infection of the neck, it is necessary to study the characteristics, the diagnosis, and the treatment. MATERIALS AND METHODS: The hundred cases of the infections of the neck in the Red Cross hospital from January in 1992 to December in 1996 were analyzed about the age and sex distribution related to spaces involved, the location of cellulitis and abscess, the side of lesion, the symptoms and signs, the etiologic events, the associated conditions, the results of culture, the special diagnostic methods, the treatments, and the complications. RESULTS: In the infections of the neck, the following contents were more frequent: male(sex), the third decade(age), pain and fever(symptoms and signs), acute tonsillitis and odontogenic origin(etiologic events), Diabetes Mellitus(associated condition), hemolytic Streptococcus and Bacteroides(the results of culture), and Computerized Tomography(the special diagnostic methods). There was no significant difference in the side of lesion. The useful treatment in the peritonsillar space infection was the incision and drainage and then tonsillectomy two or three weeks after the recovery of the infection, and in the deep neck space infection, only antibiotic therapy or the incision and drainage with the antibiotic therapy were useful. The complications were four cases with two cases of sepsis, one cases of mediastinitis, and one cases of internal jugular vein thrombosis. CONCLUSION: In spite of the antibiotic therapy and the appropriate treatment, there were some complications experieced. So, we must know the characteristics of the infection of the neck well, and the systemic and active attitude is necessary.