Run Time: 3 minutes
Author: Suzanne Chilton M.D.
- 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/