Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report
Introduction: Ludwig angina is a potentially fatal condition characterized by soft tissue infection of the submandibular, sublingual, and submental compartments. Pseudo-Ludwig angina is a rare condition characterized by sublingual swelling of non-infectious etiology, typically in the setting of supr...
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| Format: | Article |
| Language: | English |
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eScholarship Publishing, University of California
2025-01-01
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| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/93v8g0kz |
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| author | Utku Ekin Arham Hazari Nizar Alyassin Alan Alcantara Moh’d Hazem Azzam Mourad Ismail |
| author_facet | Utku Ekin Arham Hazari Nizar Alyassin Alan Alcantara Moh’d Hazem Azzam Mourad Ismail |
| author_sort | Utku Ekin |
| collection | DOAJ |
| description | Introduction: Ludwig angina is a potentially fatal condition characterized by soft tissue infection of the submandibular, sublingual, and submental compartments. Pseudo-Ludwig angina is a rare condition characterized by sublingual swelling of non-infectious etiology, typically in the setting of supratherapeutic anticoagulation. However, other etiologies, such as angioedema and trauma, have been described. Case Report: We present the case of a 59-year-old female with pseudo-Ludwig angina that developed in the setting of warfarin therapy and supratherapeutic international normalized ratio. She presented with sublingual swelling and dysphagia. She was successfully treated with dexamethasone, vitamin K, and fresh frozen plasma. The most appropriate imaging modalities in these cases are contrast-enhanced computed tomography (CT) and CT angiogram. If a hematoma is present, antibiotics for anaerobic coverage are also appropriate. Conclusion: We hope this case sheds light upon this rare pathology and ultimately hastens recognition and proper intervention. |
| format | Article |
| id | doaj-art-c6926e73c3e44dd3b22018f86d1dd45b |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2025-01-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-c6926e73c3e44dd3b22018f86d1dd45b2025-02-04T17:35:19ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2025-01-0191909410.5811/cpcem.20386cpcem-9-90Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case ReportUtku Ekin0Arham Hazari1Nizar Alyassin2Alan Alcantara3Moh’d Hazem Azzam4Mourad Ismail5St. Joseph’s University Medical Center, Department of Pulmonary and Critical Care Medicine, Paterson, New JerseySt. Joseph’s University Medical Center, Department of Pulmonary and Critical Care Medicine, Paterson, New JerseySt. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New JerseySt. Joseph’s University Medical Center, Department of Internal Medicine, Paterson, New JerseySt. Joseph’s University Medical Center, Department of Pulmonary and Critical Care Medicine, Paterson, New JerseySt. Joseph’s University Medical Center, Department of Pulmonary and Critical Care Medicine, Paterson, New JerseyIntroduction: Ludwig angina is a potentially fatal condition characterized by soft tissue infection of the submandibular, sublingual, and submental compartments. Pseudo-Ludwig angina is a rare condition characterized by sublingual swelling of non-infectious etiology, typically in the setting of supratherapeutic anticoagulation. However, other etiologies, such as angioedema and trauma, have been described. Case Report: We present the case of a 59-year-old female with pseudo-Ludwig angina that developed in the setting of warfarin therapy and supratherapeutic international normalized ratio. She presented with sublingual swelling and dysphagia. She was successfully treated with dexamethasone, vitamin K, and fresh frozen plasma. The most appropriate imaging modalities in these cases are contrast-enhanced computed tomography (CT) and CT angiogram. If a hematoma is present, antibiotics for anaerobic coverage are also appropriate. Conclusion: We hope this case sheds light upon this rare pathology and ultimately hastens recognition and proper intervention.https://escholarship.org/uc/item/93v8g0kz |
| spellingShingle | Utku Ekin Arham Hazari Nizar Alyassin Alan Alcantara Moh’d Hazem Azzam Mourad Ismail Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report Clinical Practice and Cases in Emergency Medicine |
| title | Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report |
| title_full | Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report |
| title_fullStr | Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report |
| title_full_unstemmed | Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report |
| title_short | Successful Management of Pseudo-Ludwig Angina from Supratherapeutic Warfarin Use: A Case Report |
| title_sort | successful management of pseudo ludwig angina from supratherapeutic warfarin use a case report |
| url | https://escholarship.org/uc/item/93v8g0kz |
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