Ludwig’s angina

• Ludwig’s angina is a rapidly progressive, potentially fulminant cellulitis

• involves the sublingual and submandibular spaces

• typically originates from an infected or recently extracted tooth– lower second and third molars

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• Spread of process superiorly and posteriorly elevates floor of mouth and tongue.

• In anterior spread, the hyoid bone limits spread inferiorly, causing a "bull neck" appearance

Am Fam Physician 1999;60:109-12

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Predisposing factors

• dental caries

• recent dental treatment

• sickle cell disease

• a compromised immune system

• trauma

• tongue piercing

Am Fam Physician 1999;60:109-12

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Etiologic Organisms

Common• Staphylococcus• Streptococcus• Bacteroides

Atypical • Pseudomonas• Escherichia coli• Klebsiella• Enterococcus faecalis• Candida• Clostridium

Crit Care Clin. 2003;19:55-72

J Emerg Med. 1995;13:499-503

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