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Ludwig’s angina after severe thrombocytopenia associated with dengue fever in a primigravida: A case report

Ludwig's angina is a potentially fatal condition that can result from periodontal infections that are not treated promptly. It is uncommon in pregnancy; however, it has been documented. Pregnancy causes cellular metabolic changes in the body along with a higher risk of poor dental hygiene. Tooth decay is more common among pregnant women for a variety of reasons. Dengue infection may precipitate Ludwig’s angina in an already predisposed individual due to leukopenia, gingival haemorrhage, compromised immune system, etc. We report a case of a 31-year-old primigravida, with 20 weeks period of gestation, who presented with fever, suprapubic abdominal pain. She was diagnosed with threatened abortion and dengue fever (serological test indicative of IgM positive Dengue) on admission. During the course of hospital stay she developed Ludwig’s angina and was treated conservatively with antibiotics and was discharged on 17th day of hospitalisation after complete resolution of symptoms. This case highlights that early detection and prompt intervention in a potentially lifethreatening condition like Ludwig’s angina may defer interventions like intubation, tracheostomy and surgical drainage.