重症化したLudwigアンギーナの1症例

A case of severe Ludwig angina

Ⅰ　はじめに

　Ludwigアンギーナとは舌下間隙～顎下間隙に波及した口腔底蜂窩織炎であり，扁桃炎や齲歯に起因することが多い。本疾患は早期に炎症が周囲に波及する特徴を有し，喉頭に炎症が及んだ場合は気道閉塞をきたすことがあるため，早期の診断が重要である。今回われわれは，両側顎下間隙膿瘍を伴う重症化したLudwigアンギーナの1症例を経験したので報告する。

　A 55-year-old man presented with a 3-day history of painful submandibular swelling with trismus. He was first seen in ER and was given an analgesic. His symptoms were not improved,and he was hospitalized. Despite intensive intravenous antibiotic chemotherapy,the symptoms further deteriorated,and then the patient was eventually referred to us 4 days after the first visit. He was diagnosed of Ludwig angina with laryngeal edema from the findings of fiberscopy,blood tests,and computed tomography.

　The surgical drainage of submandibular abscesses and tracheostomy were immediately underwent. He completely recovered and was discharged 28 days after surgery.