The objective of this study is to describe a case report of Ludwig’s angina of odontogenic origin, which evolved with airway obstruction requiring emergency tracheostomy. A 16-year-old adolescent was admitted with Ludwig’s angina complicated with mediastinitis, confirmed by contrast computed tomography. Antibiotic therapy and surgical drainage were instituted, but 2 days later she was admitted to the intensive care unit due to hemodynamic instability. She also evolved with airway obstruction, and emergency tracheostomy was performed. A new computed tomography scan of the cervicothoracic region was performed, which showed collections in the neck and mediastinum, with new extensive drainage and minimal thoracotomy and antibiotic escalation. She had a satisfactory clinical evolution and was discharged without sequelae after 11 days.
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