A retrospective study of ludwig’s angina at the maxillofacial unit of the komfo anokye teaching hospital-kumasi, Ghana.

Abstract

Introduction: Ludwig’s angina is a potentially life-threatening diffuse cellulitis involving the sublingual, submental, and submandibular spaces bilaterally and causing progressive airway obstruction. The microbiology of Ludwig’s angina is polymicrobial, but commonly isolated is Streptococcal spp.
Aim: The current study aimed to retrospectively evaluate the prevalence of Ludwig’s angina at the Maxillofacial Unit of the Komfo Anokye Teaching Hospital, Ghana.
Materials & Methods: A 2-year retrospective analysis of patient records from January 2012 to December 2013 was undertaken. The studied variables included the aetiology, symptoms, signs, and treatment modalities. Descriptive analysis was done using charts, frequency, and tables.
Results: The total number of admissions for maxillofacial space infections was 224, comprising 128 males and 96 females. The number of patients with Ludwig’s angina was 56, giving a prevalence rate of 25.0%. The commonest source of infection was of odontogenic origin (94.6%), and the teeth most involved were the first lower molars (37.5%). The predominant microorganisms isolated were E.coli, Klebsiella, and Pseudomonas spp. The majority of patients (94%) were managed medically and surgically with incision, drainage, and insertion of drains as well as extraction of affected teeth. The commonest antibiotic combination was amoxicillin/clavulanate potassium with metronidazole (65.5%), followed by crystalline penicillin with metronidazole (12.7%).
Conclusion: The commonest cause of Ludwig’s angina was odontogenic, and the microorganisms cultured were E. coli, Klebsiella, and Pseudomonas. The commonest antibiotic combination used for treatment was amoxicillin/clavulanate potassium with metronidazole.