Pseudo-Ludwig's Angina: Spontaneous Sublingual Haematoma Elicited by Warfarin

Spontaneous bleeding into the upper airways is a rare and potentially life-threatening complication of chronic anticoagulation. There are scarce cases in the literature demonstrating upper airway haematomas secondary to warfarin use, which is the predominant anticoagulant used by clinicians despite having a complex pharmacokinetic and pharmacodynamic profile. We report a compelling case featuring warfarin-induced sublingual haematoma, managed conservatively through the reversal of anticoagulation using fresh frozen plasma complemented by vigilant monitoring within the Intensive Care Unit (ICU).

Sublingual haematomas, though uncommon, represent potentially serious complications arising from warfarin therapy.Distinguishing sublingual haematomas from infectious processes requires a high level of clinical suspicion and is crucial for prompt management.The preferred course of action involves reversing anticoagulation with a low threshold for implementing an artificial airway in cases of compromised airways.