Definition

Ludwig's angina is a bacterial infection of the floor of the mouth. It involves swelling that may block the airway.

Alternative Names
Submandibular space infection; Sublingual space infection

Causes, incidence, and risk factors

Ludwig's angina is a type of cellulitis that involves inflammation of the tissues of the floor of the mouth, under the tongue. It often occurs after an infection of the roots of the teeth (such as tooth abscess or a mouth in!ury. "his condition is uncommon in children.

Symptoms
Swelling of the tissues occurs rapidly and may block the airway or prevent swallowing of saliva. Symptoms include#

$reathing difficulty %onfusion or other mental changes &ever 'eck pain 'eck swelling (edness of the neck )eakness, fatigue, e*cessive tiredness
+dditional symptoms that may be associated with this disease#

,arache -rooling Signs and tests

+n e*amination of the neck and head shows redness and swelling of the upper neck, under the chin. "he swelling may reach to the floor of the mouth. "he tongue may be swollen or out of place. + %" scan of the neck may be recommended. %ulture of fluid from the tissues may show bacteria.

Treatment
If the swelling blocks the airway, emergency medical help is needed to maintain an open airway. "his may involve placing a breathing tube through the mouth or nose and into the lungs, or surgery called a tracheostomy that creates an opening through the neck into the windpipe. +ntibiotics, usually penicillin or penicillin.like drug, are given to fight the infection. "hey are usually given through a vein until symptoms go away. +ntibiotics taken by mouth may be continued until tests show that the bacteria has gone away. -ental treatment may be needed to treat tooth infections that cause Ludwig's angina. Surgery may be needed to drain fluids that are causing the swelling.

Expectations (prognosis)
Ludwig's angina can be life threatening. /owever, it can be cured with proper protection of the airways and appropriate antibiotics.

Complications +irway blockage 0enerali1ed infection (sepsis Septic shock Calling your ealt care provider
$reathing difficulty is an emergency situation. Immediately go to the emergency room or call your local emergency number (such as 233 . %all your health care provider if you have symptoms of this condition, or if symptoms do not improve after treatment.

!revention
(egular visits to the dentist, and prompt treatment of mouth or tooth infections can prevent the conditions that increase the risk of developing Ludwig's angina. "evie# date$ 456656778 "evie#ed %y$ %yrus $adshah, 9.-., :h.-., +ssistant :rofessor of %linical 9edicine, %ollege of :hysicians and Surgeons, %olumbia ;niversity; +ssistant +ttending :hysician, -epartment of 9edicine, -ivision of Infectious -iseases < 9edical -irector, %hest ("$ %linic and -irectly =bserved "herapy :rogram, /arlem /ospital %enter. (eview provided by >eri9ed /ealthcare 'etwork.