title: Retrospective analysis of etiology and comorbid diseases associated with Ludwig's Angina.
abstract: BACKGROUND
  Ludwig's angina (LA) still presents regularly at our tertiary academic hospital. Various etiologies and comorbid diseases are documented worldwide, but the South African population has not been studied.
  
  
  OBJECTIVE
  To establish whether LA cases presenting to the department are different from international reports regarding etiology and comorbidities.
  
  
  METHODS
  Retrospective analysis of patients presenting with LA to a tertiary hospital.
  
  
  METHODS
  93 patients were included over a 5-year period. Archived files were analyzed for data including age, gender, comorbid diseases, etiology, airway management, and season on admission.
  
  
  METHODS
  Descriptive statistics with the inclusion of frequency distributions.
  
  
  RESULTS
  93 patients were included; 65 (69.9%) male and 28 (30.1%) female; age - minimum 20 years, maximum 75 years, mean 40.366.
  
  
  BACKGROUND
  68 (73.1%) odontogenic, 13 (14%) nonodontogenic, and 12 (12.9%) unknown cause. Comorbid diseases: 21 (22.6%) diabetes mellitus (DM), 19 (20.4%) hypertension, and 18 (19.4%) human immunodeficiency virus (HIV). Airway management: 61 (65.6%) tracheostomy and 32 (34.4%) nonsurgical.
  
  
  RESULTS
  11 (11.8%) deaths, 8 (8.60%) descending mediastinitis, and 7 (7.53%) necrotizing fasciitis. Seasonal occurrence: 30 (32.3%) spring, 24 (25.8%) winter, 22 (23.7%) summer, and 17 (18.3%) autumn.
  
  
  CONCLUSIONS
  A 2.32:1 ratio male: female presentation mirrors previous statistics. DM patients had increased risks of complications, which resulted in multiple deaths. HIV patients showed increased risks for complications with more intense, longer hospital stays, but lower percentages of deaths compared to patients with DM and complications who died. There was no statistically significant finding regarding seasonal tendency.
authors.affiliation: Department of Maxillofacial and Oral Surgery, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: Andrew
authors.initials: A
authors.lastname: Botha
authors.affiliation: Department of Maxillofacial and Oral Surgery, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: Fred
authors.initials: F
authors.lastname: Jacobs
authors.affiliation: Department of Maxillofacial and Oral Surgery, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa.
authors.forename: Corne
authors.initials: C
authors.lastname: Postma
keywords: Airway management; Ludwig's angina; comorbid diseases; complications; etiology