Case 2 - Ludwig's Angina
- Ludwig’s angina is infection within the sublingual/submandibular potential space, isolated by superficial fascia. Infection demonstrates rapid progression with posterior deflection of the tongue, obstructing the airway.
- Airway management, ENT consultation and IV antibiotics (penicillin + metronidazole, clindamycin or ampicillin/sulbactam) are the necessary steps for management of Ludwig’s angina.
- Mucositis is a common side effect of most chemotherapy and head/neck radiation regimens that is associated with significant morbidity.
- Severe mucositis carries 75% risk of serious co-infection and 9% risk of associated mortality.
Ehler's-Danlos and Aortic DIssection
- Ehler’s-Danlos Syndrome, an inheritable collagen vascular disease, is associated with hyperextensible skin and hyperflexible joints; many subtypes are at risk for arterial aneurysm, dissection or rupture at young ages.
- Management of acute aortic dissection or perforation includes vascular surgery consult (for emergent intervention) and decreased BP/sheer stress with IV nicardipine or esmolol.