LUDWIG’S ANGINA AND PARA-PNEUMONIC EFFUSION IN A CHILD: CASE REPORT

Abstract

INTRODUCTION: Ludwig’s angina as a severe odontogenic infection and para-pneumonic effusions are two distinct clinical entities withtheir unique potential challenges, spanning various specialties. Ludwig’s angina is an uncommon presentation among children and could be an indication of child neglect. The spread of severe odontogenic infections has been found to cause complications such as
parapneumonic effusion, mediastinitis, intracranial abscesses, thrombophlebitis of the internal jugular vein, empyema, pericardial
effusion, osteomyelitis of the mandible, subphrenic abscess, and aspiration pneumonia, among others. The management of both Ludwig’s angina and para-pneumonic effusion requires early aggressive medical and surgical intervention for patient survival.
CASE REPORT: In this case report, we discuss a five-year-old boy who presented with Ludwig’s angina, in whom para-pneumonic
effusion was found. He was successfully managed with a multidisciplinary approach. We also reviewed relevant clinical anatomy and the etiopathogenesis of Ludwig’s angina as a cause of para-pneumonic effusion, as well as the the diagnostic sequence of both clinical
entities.
CONCLUSION: Cervicofacial odontogenic infections can be complicated by para-pneumonic effusion, which could be fatal. Early
recognition and initiation of treatment remain key to preventing mortality. Airway observation and management, aggressive antimicrobial therapy, and surgical decompression with removal of the source of infection remain vital in the successful management of this condition. In situations where the patient is medically compromised or develops a medical complication, a multidisciplinary approach is necessary for patient management.