IMAGES IN EMERGENCY MEDICINE
Gas-forming Ludwig’s angina
Department of Emergency Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan
Correspondence to:
Dr S-J Chu, Department of Emergency Medicine, Tri-Service General Hospital, Number 325, Section 2, Cheng-Kung Road, Neihu 114, Taipei, Taiwan; d1204812@ndmctsgh.edu.tw
Accepted 3 January 2007
| The first 150 words of the full text of this article appear below. |
A 47-year-old man presented to our emergency department because of progressive swelling of the upper midline neck and dysphagia. Physical examination disclosed bilateral submandibular swelling and protrusion of the tongue. A lateral neck plain radiograph showed swelling of the submandibular region and the presence of free air (fig 1A, arrow). A subsequent contrast-enhanced CT scan showed soft tissue emphysema, fluid collection (asterisk) and fatty stranding of the mouth floor, submandibular gland, left masticator space and submandibular space (fig 1B). He was treated with surgical drainage and empirical antibiotic coverage consisting of ampicillin plus sulbactum and made an uneventful recovery.
Figure 1 (A) Lateral neck plain radiograph showing swelling of the submandibular region and the presence of free air (arrow). (B) Contrast-enhanced CT scan showing soft tissue emphysema, fluid collection (asterisk) and fatty stranding of the mouth floor, submandibular gland, left masticator space and submandibular space.
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This article has been cited by other articles:
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Buckley, M F, O'Connor, K
(2009). Ludwig's angina in a 76-year-old man. Emerg. Med. J.
26: 679-680
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