Angina in our time is successfully treatable, but it is important to understand that different forms of this disease require an individual therapeutic approach. If there is enough bed rest and antipyretic tablets in case of viral inflammation of the throat, purulent bacterial tonsillitis is treated only with antibiotics.
There are also forms of angina that require urgent surgical intervention. In such cases, the lack of medical care can lead not only to complications, but also to a fatal outcome.
Angina Ludwig
Angina of Zhenzul Ludwig is putrefactive necrotic inflammation of the orifice of the oral cavity. Similar pathological processes having a diffuse( unrestricted) nature are called phlegmon. Their danger is the possibility of rapid spread of infection to neighboring tissues.
This form of angina is caused by anaerobic( fermenting and putrefactive) microflora. Usually it is found in conjunction with streptococci, staphylococci, fusospirochetes and E. coli. Necrotic changes begin with submandibular cellulitis, later on to sublingual muscles. Possible defeat of the pharyngeal space.
Streptococcal tonsillitis, in contrast to Ludwig's angina, form purulent foci on the glands, and fungal and viral infections can not cause necrotic processes. However, lead to these processes is quite capable of a streptococcal infection.
On the photo throat with angina Ludwig
Causes of the disease
- Caries.
- Open jaw fractures.
- Injury of the oral cavity.
- Inflammation of periodontal tissue( peri-toothed tissues).
- Infection of the tonsils.
- Neoplasms and salivary stones.
- Abscesses.
Provoking Factors, Risk Group
Aggravating the main causes, necrosis of submandibular tissues can trigger:
- Decreased immunity.
- Diabetes mellitus.
- Alcoholism.
- Smoking.
- HIV / AIDS.
- Depletion.
- Non-compliance with oral hygiene.
About the causes and consequences of Ludwig's angina in our video:
Symptoms of
In adults
- Rapid progression.
- Chills.
- Temperature 38-39 ° and above.
- Arterial blood pressure lowered. Edema of the tongue, larynx, neck.
- Dense swelling under the lower jaw.
- The skin under the chin is inflamed and taut.
- Enhanced saliva production.
- Cyanotic skin color of the face, lips.
- Difficulty breathing up to suffocation.
- The necrosis of submandibular tissues.
- Putrid odor from the mouth.
- This speech is indistinct.
- Intoxication.
- Overall condition is extremely difficult.
In children
Children are much more difficult to tolerate Ludwig's angina. Any delay in treatment can cost a child a life.
To the above symptoms are added:
- Loss of consciousness.
- Delirium.
- Gastrointestinal disorders( diarrhea, spasms, vomiting).
Diagnosis
Diagnosis of such a serious illness is carried out only in a hospital.
For a preliminary diagnosis, a clinical picture is sufficient. To clarify it, the following procedures exist:
- Blood test( shows a drop in hemoglobin, an increase in COE, a decrease in the number of leukocytes).
- X-ray, MRI, CT( reveals the presence of an infiltrate in the tissues with the accumulation of gas bubbles).
- Microbiological studies( determination of pathogens).
Treatment of
by Surgical Method
When diagnosing Ludwig's angina, urgent surgical intervention is necessary:
- Opening phlegmon with drainage of focal areas and their subsequent antiseptic treatment( creating conditions for outflow of putrefactive exudate).It is done to all patients with a similar diagnosis.
- Hyperbaric oxygenation( the procedure is performed in special pressure chambers to increase oxygen in the blood).It is carried out with oxygen starvation in the presence of the necessary equipment.
- Tracheostomy( opening of the trachea with the introduction of a tube for air access).It is carried out with complete obstruction of the respiratory tract.
Surgical treatment of angina Ludwig
Medically
After surgical procedures, antibiotic treatment is mandatory, which is administered intravenously( drugs of the penicillin group together with tetracyclines).
Serum drugs against anaerobes are administered subcutaneously or intramuscularly. When intravenously administered, local anesthesia is used.
In cases of severe intoxication, droppers are placed with a large amount of saline( sodium chloride).
Used drugs to maintain cardiac activity. To enhance the action of antibiotics, sulfonamides( streptocides) are used.
In very severe cases, blood transfusion is done. Local therapy is reduced to regular gargles( Furacilin, a solution of potassium permanganate).
Folk remedies
Folk recipes in the case of Ludwig's angina are ineffective and dangerous. Use them as an additional therapy is possible, but only after consulting a doctor. In the period of remission, rinses based on medicinal herbs, saline solutions, and beekeeping products can be used. It is more reasonable for children and pregnant women to confine themselves to drug therapy.
Physiotherapy
An integrated approach to treatment reduces the likelihood of relapse and negates the effect of putrefactive flora. Therefore, during the recovery period, the doctor can prescribe the following procedures:
- Irradiation of the oral cavity with ultraviolet.
- Electrophoresis.
- Magnetotherapy.
- Laser treatment.
Video demonstration of a surgical operation of a patient with angina Ludwig:
Features of treatment for pregnancy
Angina Ludwig is deadly both for the future mother and her baby. In case of occurrence of characteristic symptoms, it is important to immediately hospitalize the patient and to entrust all the further treatment actions to a competent specialist.
- The greatest danger is the possibility of suffocation.
- Large doses of antibiotics often provoke intrauterine pathologies.
- Fainting conditions can lead to injuries and miscarriages.
- High temperature is dangerous for the fetus, but it can not be reduced with aspirin. A tablet of paracetamol and wiping the feet with acetic and alcoholic solution will help lower the temperature before the arrival of an ambulance. In the hospital, antipyretic drugs are administered intramuscularly.
- During your stay in the hospital you need to carefully monitor your personal hygiene.
- Inhalations and other thermal procedures for pregnant women are strictly contraindicated.
Possible complications than dangerous disease
Complications in the further stages of treatment occur less often, but in the presence of concomitant diseases and immunodeficiency the following consequences are possible:
- Gas gangrene.
- Abscesses.
- Infection of the blood.
- Meningitis.
- Mediastinitis.
- Toxic shock.
Prevention
The main preventive actions include:
- Timely treatment of caries.
- Regular brushing of teeth.
- In the presence of wounds and burns in the oral cavity, their timely processing is necessary.
- Qualified therapy for small foci of infection.
In the hospital patient is isolated from other patients. In the room where the victim is, disinfection activities are carried out:
- Disinfection of dishes, linen and other items of use.
- Daily wet cleaning.
- Regular ventilation.
Contacts with healthy people to a minimum are limited. When contacting you should wear a gauze dressing and regular hand treatment.
Prevention of sore throat:
Forecast
Before the appearance of antimicrobial agents in this form of angina, mortality exceeded 50% of the total number of victims. In our time the forecast is more consoling.
A few days after the operation, there is a significant improvement in the condition. Wound healing in most cases occurs without complications.