When Is “Pseudo-Ludwig’s Angina” Associated with Coagulopathy Also a “Pseudo” Hemorrhage?

Details

• Personal Author:
  Blanc, Paul ; Chin C ; Durrani TS ; Erickson M ; Lovallo E ; Patterson S
• Description:
  Sublingual hematoma secondary to short-acting anticoagulants such as warfarin has been labeled "pseudo-Ludwig's angina" to distinguish it from the classic syndrome of localized infection and swelling involving the upper airway. Sublingual hematoma with airway compromise secondary to brodifacoum, a common long-acting anticoagulant rodenticide, has only been reported in the veterinary literature. We report a case of massive tongue swelling and impending airway compromise in the context of an intentional long-acting anticoagulant ingestion leading to coagulopathy. The swelling was initially presumed to be due either to infection or hemorrhage, but this was not supported by computed tomography scan imaging. Instead, the patient's clinical course was consistent with corticosteroid-responsive angioedema, temporally associated with the ingested brodifacoum. [Description provided by NIOSH]
• Subjects:
  Occupational Health Respiratory System Safety
• Keywords:
  Airway Obstruction Angioedema Anticoagulants Author Keywords: Ludwig's Angina Biological Effects Brodifacoum Hemorrhage Sublingual Hematoma Warfarin
• ISSN:
  2324-7096
• Document Type:
  Text
• Funding:
  Grant
• Genre:
  Journal Article
• Place as Subject:
  California ; OSHA Region 9
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-3
• Volume:
  1
• Issue:
  2
• NIOSHTIC Number:
  nn:20053642
• Citation:
  J Investig Med High Impact Case Rep 2013 Apr-Jun; 1(2):1-3
• Contact Point Address:
  Timur S. Durrani, Division of Clinical Pharmacology and Experimental Therapeutics, University of California, San Francisco, Box 1369, San Francisco, CA 94110, USA
• Email:
  timur.durrani@ucsf.edu
• CAS Registry Number:
  (±)-Warfarin (CAS RN 81-81-2)
• Federal Fiscal Year:
  2013
• Performing Organization:
  University of California, Berkeley
• Peer Reviewed:
  True
• Start Date:
  20050701
• Source Full Name:
  Journal of Investigative Medicine High Impact Case Reports
• End Date:
  20250630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:a427220e82b4553fdd43672e980df5389e271c8f15c97a7cd988fa0c78a7db74279d5688a77d047865db4888d9bb4a2674d948eb544d05efc8e4a43d87d6d82f
• Download URL:
  https://stacks.cdc.gov/view/cdc/216363/cdc_216363_DS1.pdf
• File Type:
  [PDF - 99.11 KB ]