OpenHealth Q&A

Unexpected Torso Bruising After Ludwig’s Angina Hospitalization

I appreciate any insights you can offer! I am a 47-year-old woman with a medical background including ulcerative colitis, which led to a complete colectomy and j-pouch creation in 1998 and 1999 due to toxic megacolon. Additionally, I have polycystic ovary syndrome (PCOS) and recently underwent a uterine ablation in May 2025. I also cope with PTSD largely due to past medical traumas. Currently, I'm on a regimen that includes duloxetine, buspirone, prazosin, and amitriptyline. I take phenergan when necessary and use cannabis-based edibles for nausea related to my previous colitis condition, especially under my medical card. Last Sunday, I began experiencing discomfort in my lower left jaw, which escalated by the evening to a near intolerable level of pain. My dentist examined me the following day, diagnosing a molar abscess. He prescribed antibiotics, specifically amoxicillin, and recommended an endodontist for further treatment. I began the amoxicillin on Monday at 2 PM and also took Tylenol for relief. By Monday night, I had not shown any significant swelling. However, overnight on Monday into Tuesday, my face and neck swelled dramatically, making my appearance quite alarming—comparable to that of a bullfrog. The pain persisted intensely, and my neck/jaw area became red and heated. I struggled initially to swallow and then started feeling like I was not getting enough air. Concerned, I called my dentist, who advised me to head to the emergency room right away. Upon my arrival at the ER Tuesday afternoon, I underwent triage, blood tests, and a CT scan with contrast, which resulted in a diagnosis of Ludwig’s Angina. I was immediately started on IV antibiotics and admitted to the hospital. I remained hospitalized for a total of five days. The primary objectives during my stay were pain management and reducing both swelling and infection. I received IV antibiotics every 4 to 6 hours, in addition to oral gabapentin three times daily. Initially, I was on IV pain relievers, specifically toradol and dilaudid, which were phased out before my discharge. I am now prescribed 5 mg oxycodone every 4-6 hours for pain management. Additionally, I received a daily oral prebiotic and nightly lovenox injections, as well as simethicone to alleviate digestive issues caused by the antibiotics. Upon my return home today, I noticed several small purple bruises—approximately 10 to 12—on my torso, roughly the size of a quarter. They are located on both sides of my body and do not cause pain nor feel warm. I cannot recall any incidents or activities that might have led to these bruises. Concerned, I did some quick research and found that such bruising could be indicative of sepsis or other blood-related conditions, which worried me given my severe infection and cellulitis from Ludwig’s angina. Therefore, my question is whether I should seek immediate attention at the ER again, or if it is acceptable to wait until I can follow up with my primary care physician early next week. Thank you for any assistance during this daunting and painful chapter. Please let me know if you need further details! I am truly grateful for any guidance.

Answers (1)

6/21/2025, 11:10:35 PM

OpenHealth AI

Thank you for sharing your comprehensive medical history and your current situation. I understand that this can be a particularly stressful time for you, especially after your recent hospitalization for Ludwig’s Angina. Let's address your concerns regarding the unexpected bruising on your torso.

Main Points:

1. The bruising may be due to various reasons, including medications, recent trauma, or a reaction to the infection and treatment.
2. While the bruises are concerning, it may not require immediate emergency attention unless accompanied by other severe symptoms.

Explanation:

Bruising can occur for several reasons, some of which may be related to your recent hospital stay and treatment for Ludwig’s Angina. Some possibilities include:

• Medication Effects: Certain medications, including anticoagulants like Lovenox (enoxaparin) and even some pain medications, can increase the tendency to bruise.
• Infection Response: The body’s response to infection or inflammation can sometimes cause capillaries to leak, resulting in bruising.
• Physical Trauma: Although you do not recall any incidents, minor trauma (like IV placement or hospital activities) can cause bruising that might not be immediately noticeable.
• Blood Disorders: Although less common, unexplained bruising can sometimes indicate a blood clotting disorder or other serious condition, especially post-infection.

Next Steps:

Here’s what you should consider as immediate actions:

1. Monitor Symptoms: Over the next day or two, keep an eye on the bruises. Check for any new symptoms like worsening pain, increased swelling, or changes in your breathing. If you notice any severe changes, such as difficulty breathing, a rapid heart rate, or significant pain, seek immediate medical attention.

2. Keep an Eye on the Bruises: Many bruises will resolve on their own over time. Ensure they don’t develop into larger areas of discoloration, become painful, or show signs of unusual changes.

3. Follow-Up Appointment: Since you’re due to follow up with your primary care physician early next week, contact their office to mention the new symptoms. They may want to see you sooner based on your history and current condition.

4. Documentation: Consider documenting when you first noticed the bruising and any other symptoms you experience. This information will be valuable for your healthcare provider during your next visit.

Reassurance:

It’s understandable to feel anxious about these developments, especially after dealing with a significant health challenge. Please remember that bruising, while concerning, is often a benign reaction to treatment or injury. However, staying vigilant and communicating with your healthcare team is wise. Don’t hesitate to reach out with any further concerns or changes in your condition. You’re doing great in managing this journey, and support is available every step of the way.