Ludwig's Angina: An Autopsy Case.

Na, Joo Young; Ham, Suk Hoon; Oh, Yeon Ho; Lee, Sung Su; Kim, Hyung Seok; Park, Jong Tae

doi:2015.39.4.127

Korean J Leg Med > Volume 39(4); 2015 > Article

Case Report

Korean Journal of Legal Medicine 2015;39(4):127-131.
DOI: https://doi.org/10.7580/kjlm.2015.39.4.127 Published online November 30, 2015.

Ludwig's Angina: An Autopsy Case.

Joo Young Na, Suk Hoon Ham, Yeon Ho Oh, Sung Su Lee, Hyung Seok Kim, Jong Tae Park

¹Forensic Medicine Division, National Forensic Service Gwangju Institute, Jangseong, Korea. pdrdream@gmail.com
²Department of Otolaryngology-Head and Neck Surgery, Chonnam National University Medical School, Gwangju, Korea.
³Department of Forensic Medicine, Chonnam National University Medical School, Gwangju, Korea.

Abstract

Ludwig's angina is a progressive gangrenous cellulitis and edema of the soft tissues of the neck and floor of the mouth. Ludwig's angina can be fatal as a result of progressive swelling of the soft tissues of the neck and elevation and posterior displacement of the tongue, resulting in airway obstruction. We report the case of a 77-yearold man who was admitted to the dental hospital with a toothache and headache. He was diagnosed with left submandibular space abscess. Four days post-admission, the submandibular and submental abscess was incised and drained. After the operation, the patient suddenly developed dyspnea and suffered cardiopulmonary arrest and died. An autopsy was performed, and exploration of the neck revealed a submental and submandibular abscess with massive inflammation, edema, and an abscess in multiple layers of the cervical subcutaneous tissue. After autopsy, the cause of death was confirmed as Ludwig's angina with a deep neck abscess. Ludwig's angina is a rapidly progressive cellulitis that often results in death by asphyxia or sepsis and is rarely seen in a forensic autopsy practice. Here in we report a case of Ludwig's angina and present a review of the literature.

Key Words: Ludwig's angina, Autopsy, Asphyxia