Bulletin of Stomatology and Maxillofacial Surgery
ISSN 1829-006X
2025; 262–265
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FROM FRACTURE TO AIRWAY THREAT: A CASE OF LUDWIG’S ANGINA FOLLOWING MANDIBULAR FRACTURE

Received: 2026-04-08 · Published: 2025-05-30

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Original title
FROM FRACTURE TO AIRWAY THREAT: A CASE OF LUDWIG’S ANGINA FOLLOWING MANDIBULAR FRACTURE
Author
Rohit Singh
Source journal
Bulletin of Stomatology and Maxillofacial Surgery
Published
2025-05-30
Licence
Creative Commons Attribution-NonCommercial 4.0 International
Original
https://doi.org/10.58240/1829006X-2025.21.4-262

Abstract

Background: Ludwig’s angina is a rapidly progressive, potentially fatal cellulitis of the floor of the mouth and neck, often arising from odontogenic or mandibular infections. Prompt surgical intervention and appropriate antimicrobial therapy are critical for successful outcomes. Case Presentation: A 53-year-old male presented to the emergency department with severe facial swelling, trismus, dysphagia, and signs of airway compromise. Clinical and radiographic evaluation revealed an untreated, intraorally open mandibular fracture complicated with Ludwig’s angina, necessitating urgent surgical intervention. Management and Outcome: Under general anesthesia, bilateral submandibular stab incisions were made for Surgical Decompression, debridement, and irrigation with gentamicin and metronidazole, followed by placement of corrugated drains, and then ORIF of mandibular and maxillary fractures was performed. Postoperatively, the patient received intravenous antibiotics, corticosteroids, NSAIDs, and fluid support. Microbiology report revealed diphtheroids on POD-4, and Gentamicin was added to drug regimen. Drains were removed on POD-5, surgical closure of the stab incisions was done on POD-12 following the resolution of infection, and the patient was discharged. Conclusion: This case underscores the importance of early surgical intervention, multidisciplinary care, and adaptive antimicrobial strategies for managing complex facial trauma complicated by deep space infections, such as Ludwig’s angina.
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