Ahrens A. GSM*, Bressi T.**
* D.D. Private Dental Clinic in Nocciano, (Pe) – Italy, ahrens1@tin.it
** M.D. ENT Department, University hospital, Perugia, Italy
Abstract
Ludwig’s Angina is a bacterial infection of the submandibular and sublingual
space, usually following an infection of the roots of the teeth (such as a tooth
abscess).
The main symptoms are pain and swelling of the tissues, fever, weakness, excessive
tiredness and difficulty breathing (this symptom indicates an emergency situation).
We report a case of a patient involving Ludwig’s Angina after a tongue’s
frenum piercing.
Introduction
Ludwig’s Angina is a bacterial infection of the floor of the mouth which
involves an inflammation of the tissues located under the tongue and which usually
occurs as the result of a tooth abscess, or an injury of the mouth. The swelling
of the tissues occurs quickly and may also block the airway or prevent the swallowing
of saliva.
The common symptoms are pain, fever, swelling, weakness, excessive tiredness,
mental confusion, difficulty breathing. Sometimes to these symptoms may be associated
earache and drooling.
Case Report
A 25 years old female was
visited in our private dental clinic ‘cause of the swelling of the floor
of the mouth that the patient supposed could be related to a tooth abscess.
By recording all the data of the patient we reported that she underwent a piercing
of the tongue’s frenum two weeks before.
The tongue was displaced upward and backward ‘cause of the inflammation.
To evaluate the origins of this infections we have subjected the patient to
panoramic and endoral radiographs. No lesions of the roots of the teeth were
reported. Only some decays were recorded. We decided to get a culture of the
fluid of the tissue and the result showed staphylococcus bacteria.
To cure the infection we administrated the patient with intravenous antibiotics
until the remission of the symptoms, and then we gone on with oral antibiotics
until the result of repeated culture showed the complete absence of bacteria.
Discussion
The oral piercing, although perceived as a safe practice, could involve in some
complications, related not only to damages of teeth and periodontal tissue (1,2,3,4,5).
Many authors demonstrated the wide range of complications related by the piercing
practice (6,7,8,9,10)
Our case report according to the work of Furst IM, Ersil P. and Caminiti M.
(11) shows the importance that the dentists should be able to recognize the
signs and symptoms of this pathology relating to its life-threatening, although
it is uncommon, because a quick referral to an oral or maxillofacial surgeon
in the severe cases or a good a administrated therapy will minimize the morbidity
and mortality of this serious infection.
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