Superior vena cava syndrome is a medical emergency. The morbidity and mortality of superior vena cava syndrome can be decreased by early recognition, early establishment of primary cause, early supportive and definitive treatment. We illustrate a case of 53-year-old male with underlying advanced Parkinsonism and ischemic stroke who presented with superior vena cava syndrome over 4 days period. Diagnostic challenge in this patient lies in the fact that patient had aphasia and his daily living activity was dependent. Most of the information was based on caretaker’s observations. A strong clinical suspicion based on clinical history is crucial for early diagnosis and treatment of superior vena cava syndrome.
Ludwig angina is a fulminant condition that is potentially lethal. If left unrecognized or untreated, this condition carries a mortality rate of up to 50%. We illustrate a case of 43-year-old male who presented with signs and symptoms of Ludwig angina over a period of two days. The patient had history of tooth extraction prior to the onset of symptoms. Despite typical clinical presentation, Ludwig angina was not considered during the first visit to medical. Ludwig angina is a clinical diagnosis that requires high index of suspicion. Delay in the diagnosis increase the risk of airway obstruction due to its rapidly spreading oedema of the upper airway.