Ludwig's angina is an infection of the floor of the mouth under the tongue. It is due to bacteria.
Submandibular space infection; Sublingual space infection
Causes, incidence, and risk factors
Ludwig's angina is a type of skin infection that occurs on the floor of the mouth, under the tongue. It often develops after an infection of the roots of the teeth (such as tooth abscess) or a mouth injury.
This condition is uncommon in children.
The infected area swells quickly. This may block the airway or prevent you from swallowing saliva.
Speech that is unusual and sounds like the person has a "hot potato" in the mouth
Signs and tests
Your health care provider will do an exam of your neck and head to look for redness and swelling of the upper neck, under the chin.
The swelling may reach to the floor of the mouth. Your tongue may be swollen or out of place.
You may need a CT scan of the neck. A sample of the fluid from the tissue may be sent to the lab to test for bacteria.
If the swelling blocks the airway, you need to get emergency medical help right away. A breathing tube through your mouth or nose and into the lungs to restore breathing. You may need to have surgery called a tracheostomy that creates an opening through the neck into the windpipe.
Antibiotics are given to fight the infection. They are usually given through a vein until symptoms go away. Antibiotics taken by mouth may be continued until tests show that the bacteria have gone away.
Dental treatment may be needed for tooth infections that cause Ludwig's angina.
Surgery may be needed to drain fluids that are causing the swelling.
Ludwig's angina can be life threatening. However, it can be cured with getting treatment to keep the airways open and taking antibiotic medicine.
Christian JM. Odontogenic infections. In: Cummiongs CW, Flint PW, Haughey BH, et al. Otolaryngology: Head & Neck Surgery. 5th ed. Philadelphia, Pa: Mosby Elsevier;2010:chap 12.
Ashutosh Kacker, MD, BS, Associate Professor of Otolaryngology, Weill Cornell Medical College, and Associate Attending Otolaryngologist, New York-Presbyterian Hospital, New York, NY. Review provided by VeriMed Healthcare Network. Also reviewed by A.D.A.M. Health Solutions, Ebix, Inc., Editorial Team: David Zieve, MD, MHA, Bethanne Black, Stephanie Slon, and Nissi Wang.