title: Ludwig's angina: an uncommon cause of chest pain.
abstract: A 71-year-old male with coronary artery disease, hypertension, diabetes mellitus, tobacco and opioid dependence came to the emergency room complaining of one episode of retrosternal chest pain oppressive in nature of one day of evolution. He had acute respiratory distress and required mechanical ventilation. The initial impression was myocardial ischemia, but electrocardiography and cardiac enzymes ruled it out. During the following hours, neck and tongue edema developed. He was started on broad-spectrum antibiotics empirically. Neck computed tomography scan revealed a left parapharyngeal and submandibular abscess. The abscess was drained. The source of infection was found on the second molar of the left lower jaw. The patient improved and was successfully weaned from mechanical ventilation. Despite advances in therapy, Ludwig's angina remains a potentially lethal infection in which early recognition plays a crucial role.
authors.affiliation: Pulmonary and Critical Care Section, San Juan Veterans Affairs Medical Center, San Juan, Puerto Rico. meocasio@yahoo.com
authors.forename: María Elena
authors.initials: ME
authors.lastname: Ocasio-Tascón
authors.forename: Miriam
authors.initials: M
authors.lastname: Martínez
authors.forename: Arturo
authors.initials: A
authors.lastname: Cedeño
authors.forename: Alfonso
authors.initials: A
authors.lastname: Torres-Palacios
authors.forename: Edwin
authors.initials: E
authors.lastname: Alicea
authors.forename: William
authors.initials: W
authors.lastname: Rodríguez-Cintrón
mesh_terms: D000038:Abscess / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D000368:Aged; D002637:Chest Pain / Q000209:etiology*; D005491:Focal Infection, Dental / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D008158:Ludwig's Angina / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D008297:Male; D008480:Mediastinitis / Q000150:complications* / Q000000981:diagnostic imaging / Q000628:therapy; D014057:Tomography, X-Ray Computed