Podcast #162: Jaw Infections

1e060aa3-b451-45a8-9b7c-7ff5fc99ee60Run Time:  3 minutes

Author: Suzanne Chilton M.D.

Educational Pearls:

  • Patient presentation: 2 weeks of mouth pain, no recent dentist visit, low grade fever, and muffled or hot potato voice.
  • Patient exam: swollen tongue that is located up and back in the mouth, edema under tongue, diffuse erythema, and rancid breath.
  • This patient has Ludwig’s Angina – a potentially life-threatening cellulitis of the lower jaw space.
  • The infection starts from a dental infection – most commonly between the 2nd & 3rd molar because roots of these teeth go into a space between the muscles of the head and neck that can reach down to the anterior neck.
  • The most serious complication for patients is maintaining their airway. Patients should be placed in a room with advanced airway management and a cricothyrotomy kit near by.
  • Treatment is broad spectrum antibiotics that targets anaerobes, and oral flora such as clindamycin or unasyn with flagyl.
  • Steroids will help with the swelling – patients have a 65% less chance of intubation if they are given steroids.

Link to Podcast: http://medicalminute.madewithopinion.com/jaw-infections/

References: http://www.ncbi.nlm.nih.gov/pubmed/18952475

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