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What is Ludwig’s angina?

What is Ludwig’s angina?

A: Ludwig’s angina is an aggressive infection of the mouth floor and neck that can have very serious consequences. The most immediate threat the rapidly spreading infection poses is the possibility of restricting the airway and suffocating the victim.

Now that antibiotics and aggressive airway saving procedures are widely used, Ludwig’s angina does not kill half of its victims as it did in the past but instead only about 8 percent. Nevertheless, if not treated early, serious consequences can result requiring multiple surgeries, feeding tubes, months of rehabilitation and neck scarring.

More than 90 percent of cases result from dental issues, particularly infections of the second and third molar teeth of the lower jaw. The reason is that these teeth’s roots penetrate deeply enough to allow the infection to spread widely and rapidly. Other cases can be caused by broken jaw bones, tongue piercing, neck trauma and infections of the salivary glands or other areas of the neck and jaw.

Though most cases involve healthy individuals, certain conditions predispose patients to Ludwig’s angina. Anyone with a compromised immune system is more likely to suffer from Ludwig’s angina. Immune systems can be compromised due to several factors including HIV, diabetes, organ transplant and alcoholism.
In addition, acute glomerulonephritis, systemic lupus erythematosus, aplastic anemia, neutropenia, and dermatomyositis all increase one’s risk of developing Ludwig’s angina

Symptoms include neck pain and swelling, often following recent dental work. Some will experience difficulty breathing. More than 95 percent of cases involve swelling below the jaw line on both sides of the jaw.

Treatment requires airway maintenance and broad spectrum antibiotics including combinations of penicillin, clindamycin and metronidazole.

To read a short case study involving negligent treatment of Ludwig’s angina, read this Florida medical malpractice attorney article.


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