Ludwig angina
Ludwig's angina is a type of severe cellulitis that affects the submandibular space of the neck. It is a serious, potentially life-threatening condition that requires immediate medical attention. The condition is characterized by the rapid onset of swelling in the neck, which can lead to difficulties in breathing and swallowing. The primary cause of Ludwig's angina is an infection, usually originating from the roots of the teeth (odontogenic) such as a tooth abscess or from a peritonsillar abscess. Bacteria involved are typically part of the normal oral flora, including Streptococcus spp., Staphylococcus spp., and anaerobes such as Bacteroides. Symptoms of Ludwig's angina include severe pain and swelling in the neck, redness of the overlying skin, difficulty swallowing (dysphagia), difficulty speaking (dysphonia), and difficulty breathing (dyspnea). Fever and an increased heart rate (tachycardia) may also be present. Diagnosis of Ludwig's angina is primarily clinical, supported by medical history and physical examination. Imaging studies, such as a Computed Tomography (CT) scan or Magnetic Resonance Imaging (MRI), can be used to assess the extent of the infection and involvement of surrounding structures. Treatment of Ludwig's angina typically involves antibiotics to combat the infection and, in severe cases, surgical intervention to relieve pressure in the affected area and remove the source of infection. Airway management is critical, and in some cases, an emergency tracheotomy may be necessary to secure the airway. Prevention of Ludwig's angina involves maintaining good oral hygiene and promptly addressing dental infections and other potential sources of infection in the head and neck region.
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Contributors: Prab R. Tumpati, MD