title: [Airway management in Ludwig's angina - a challenge: case report].
abstract: BACKGROUND
  Ludwig's angina (LA) is an infection of the submandibular space, first described by Wilhelm Frederick von Ludwig in 1836. It represents an entity difficult to manage due to the rapid progression and difficulty in maintaining airway patency, a major challenge in medical practice, resulting in asphyxia and death in 8-10% of patients.
  
  
  OBJECTIVE
  Describe a case of a patient with Ludwig's angina undergoing surgery, with emphasis on airway management, in addition to reviewing the articles published in the literature on this topic.
  
  
  METHODS
  Male patient, 21 years, drug addict, admitted by the emergency department and diagnosed with LA. Difficult airway was identified during the anesthetic examination. In additional tests, significant deviation from the tracheal axis was seen. Undergoing bilateral thoracoscopic pleural drainage, we opted for airway management through tracheal intubation using fiberoptic bronchoscopy, and balanced general anesthesia was proposed. There were no complications during the surgical-anesthetic act. After the procedure, the patient remained intubated and mechanically ventilated in the intensive care unit.
  
  
  CONCLUSIONS
  Airway management in patients with Ludwig's angina remains challenging. The choice of the safest technique should be based on clinical signs, technical conditions available, and the urgent need to preserve the patient's life.
authors.affiliation: Propedêutica Cirúrgica e Anestésica da Universidade de Caxias do Sul, Unidade de Ensino Médico, Caxias do Sul, RS, Brasil; Clínica de Anestesiologia de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Roberto Taboada
authors.initials: RT
authors.lastname: Fellini
authors.affiliation: Propedêutica Cirúrgica e Anestésica da Universidade de Caxias do Sul, Unidade de Ensino Médico, Caxias do Sul, RS, Brasil; Clínica de Anestesiologia de Caxias do Sul, Caxias do Sul, RS, Brasil; Comissão Examinadora do Título Superior em Anestesiologia, Porto Alegre, RS, Brasil. Electronic address: danielvolquind@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Volquind
authors.affiliation: Hospital Santa Rita, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil.
authors.forename: Otávio Haygert
authors.initials: OH
authors.lastname: Schnor
authors.affiliation: Curso de Medicina da Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Marcelo Gustavo
authors.initials: MG
authors.lastname: Angeletti
authors.affiliation: Propedêutica Cirúrgica e Anestésica da Universidade de Caxias do Sul, Unidade de Ensino Médico, Caxias do Sul, RS, Brasil; Clínica de Anestesiologia de Caxias do Sul, Caxias do Sul, RS, Brasil; Comissão Examinadora do Título Superior em Anestesiologia, Porto Alegre, RS, Brasil; Hospital Santa Rita, Complexo Hospitalar Santa Casa de Misericórdia de Porto Alegre, Porto Alegre, RS, Brasil; Curso de Medicina da Universidade de Caxias do Sul, Caxias do Sul, RS, Brasil.
authors.forename: Olívia Egger de
authors.initials: OE
authors.lastname: Souza
mesh_terms: D058109:Airway Management / Q000379:methods; D000758:Anesthesia; D006801:Humans; D008158:Ludwig's Angina; D008297:Male
keywords: Airways; Angina de Ludwig; Ludwig's angina; Mediastinite; Mediastinitis; Vias aéreas