Ludwigs angina

Definition^​1​

Rapidly spreading cellulitis of floor of mouth and submandibular space (submaxillary or submental and sublingual divided by mylohyoid) secondary to:

1. Soft tissue infection
2. Tonsil infection
3. Lower premolar or molar infection (80%)
4. Submandibular sialadenitis
5. Injuries to the oral mucosa

Wilhelm Friedrich von Ludwig – 1836, Described 5 cases.

Symptoms

Trismus, odynophagia, Mouth pain, stiff neck, drooling, and dysphagia, May lean forward to maximize the airway diameter Muffled voice or be unable to speak at all, Signs of toxicity tachycardia, tachypnoea, pallor, fever, diaphoresis, Trismus – indicative of secondary space involvement ¢ ¢Ominous signs: stridor, cyanosis,
Excessive salivation
Tongue is pushed upwards and backwards due to edema of the floor of the mouth.

Extent

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