![]() General: Awake, diaphoretic male in mild respiratory distress Examination of the patient’s oral cavity reveals several cavities, dry oral mucosae, and woody, tender edema of the floor of the mouth and anterior neck.Įvaluation of the patient reveled the following: He also notes a foul taste in his mouth and difficulty swallowing. The patient tells you that for the last 2 days, he has had malaise, felt feverish, and his blood sugar has been elevated. In addition, a note in the chart cautions that he is a “drug-seeker” and not to give him narcotics. The patient’s records contain multiple notes indicating that he says he cannot afford to get his teeth pulled. Despite multiple referrals to a local dentist, he continues to frequent the urgent care center and has not sought dental care. ![]() Review of his past medical records reveals he has visited the center on multiple occasions, typically complaining or oral pain caused by dental caries. 2Ī 42-year-old male with type 1 diabetes presents to the urgent care clinic with a 2-day history of fever, chills, and facial swelling. The latter condition is of particular concern because if left untreated, it has the potential to cause sepsis, obstruct the airway, and cause respiratory collapse requiring an emergency surgical airway. In children, tonsillitis is the most common cause of Ludwig’s Angina or deep neck space infections, whereas an odontogenic origin is the leading factor in adults. 1 This condition usually presents in individuals who have dental infections, are immunocompromised and/or have poor oral hygiene. The two compartments affected are the sublingual space and the submylohyoid space. More specifically, it is a bilateral infection of the submandibular space. ![]() Ludwig’s angina is a serious and potentially life-threatening connective tissue infection found on the floor of the mouth and in the deep neck spaces. Urgent message: Thoroughly evaluate patients who complain of dental or oral pain.ĬHRISTOPHER MCKENNA and JOHN SHUFELDT, MD, JD, MBA, FACEP ![]()
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