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VOLUME 7 , ISSUE 1 ( January-April, 2015 ) > List of Articles

CASE REPORT

Superior Vena Cava Syndrome vs Ludwig's Angina: A Diagnostic Dilemma

Balamugesh Thangakunam, Ramanathan Chandrasekharan, Amit Kumar Tyagi, Gaurav Ashish, Ann Mary Augustine, Ajoy Mathew Varghese, Harshad Parmar, DJ Christopher

Citation Information : Thangakunam B, Chandrasekharan R, Tyagi AK, Ashish G, Augustine AM, Varghese AM, Parmar H, Christopher D. Superior Vena Cava Syndrome vs Ludwig's Angina: A Diagnostic Dilemma. Int J Otorhinolaryngol Clin 2015; 7 (1):19-22.

DOI: 10.5005/aijoc-7-1-19

License: CC BY-NC 3.0

Published Online: 01-03-2013

Copyright Statement:  Copyright © 2015; The Author(s).


Abstract

Introduction

We present an interesting diagnostic dilemma between superior vena cava syndrome and Ludwig Angina to highlight ways to differentiate between these two seemingly similar conditions.

Presentation of case

A 50-year-old man presented with complaints of progressive breathing difficulty with diffuse brawny swelling in the neck and clinically gave impression of Ludwig angina, however, on further evaluation was diagnosed with superior vena cava syndrome (SVCS) secondary to non small cell carcinoma of lung.

Discussion

This paper illustrates an interesting scenario in which clinical presentation of SVCS mimicked Ludwig's Angina. SVCS with a gradual onset may have minimal symptoms with facial edema, erythema and venous distension in the chest and neck. Occasionally atypical presentation of Ludwig's angina may mimic SVCS where high degree of clinical suspicion is needed to discriminate them.

Conclusion

Superior vena cava syndrome may present with symptoms suggestive of Ludwig's angina, especially if the obstruction is slowly progressive. A high index of suspicion is necessary in these cases.

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