A rare case of Ludwigs angina after viper bite

Description

A previously healthy 20-year-old woman presented to our Accident and Emergency Department of Degehbur Hospital, a small district hospital in Somali region of Ethiopia, with complaints of rapidly progressive swelling in her neck and difficulty in swallowing for the past 2 days (figures 1 and 2). She was bitten by a snake, which was later identified as a viper, over her right lower jaw while sleeping on the floor. She did not seek any medical treatment until day 3 when the swelling became worse and involved both submandibular region and the tongue. She also complained of rapidly increase shortness of breath for the past 24 hours.

Figure 1

The patient presented to emergency department with severe swelling of her tongue, neck and submandibular area.

Figure 2

Lateral view of the patient showing severe submandibular swelling that obscuring the airway.

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