Ludwig's angina in a child: a rare clinical case with complication of mediastinitis

S.M.R.S., male, 8 years old, presented with odynophagia, prostration, fever, and dental caries, progressing to cervical pain and swelling in the cervical region, without respiratory insufficiency. A CT scan of the neck and chest was performed, showing an infectious process in the submandibular and submental regions, with cervical and left retro-pharyngeal extension and involvement of the mediastinal area. A diagnosis of Ludwigs angina was made, with complications leading to mediastinitis. Treatment was carried out with antibiotic therapy and surgical intervention, without airway compromise, resulting in complete improvement. The aim of this report was to describe a case of a serious and potentially fatal condition in pediatrics, highlighting the rapid diagnostic and therapeutic approach. Methodologically, clinical data were collected to correlate with the literature, supporting scientific evidence. Ludwigs angina (LA) is an infectious pathology affecting the primary mandibular spaces (submandibular, sublingual, and submental), initially stemming from odontogenic infections and upper airway infections. Clinically, it presents with fever, dysphagia, odynophagia, cervical edema, sialorrhea, cervical pain, and dysphonia, and may progress to respiratory insufficiency due to extrinsic airway compression and sepsis. The diagnosis is based on clinical evaluation, supplemented by imaging studies. Treatment involves airway management, antibiotic therapy, and surgical intervention in certain cases. Due to the risk of potentially fatal complications, it is a medical emergency that stands out in the differential diagnosis of cervical masses in children.