Ludwigs Angina - Symptoms and Treatment

Ludwig's angina is a potentially life-threatening, rapidly expanding, diffuse inflammation of the submandibular and sublingual spaces that occurs most often in young adults with dental infections. It is named after the German physician, Wilhelm Frederick von Ludwig who first described this condition in 1836 . Ludwig's angina should not be confused with angina pectoris , which is also otherwise commonly known as " angina ". The word " angina " comes from the Greek word ankhon , meaning "strangling", so in this case, Ludwig's angina refers to the feeling of strangling, not the feeling of chest pain, though there may be chest pain in Ludwig's angina if the infection spreads into the retrosternal space.

Common symptoms include fever, chills, facial pain and an inability to open the mouth (trismus). Stiffness of tongue movements, difficulty breathing or swallowing, and a muffled voice are noticeable in more advanced cases. Treatment requires hospitalization and high doses of intravenous antibiotics are necessary. A surgical procedure to drain the infection may be performed in some cases. Advanced airway (breathing) support may be necessary. An ENT specialist is the expert in the management of this problem.

Causes of Ludwigs Angina

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 following an infection of the roots of the teeth or after a mouth injury. Swelling of the tissues occurs rapidly and may block the airway or prevent swallowing of saliva. This condition is uncommon in children.

Signs and Symptoms of Ludwigs Angina

Sign and symptoms may include the following :

• Fever.
• Confusion or other mental changes .
• Weakness, fatigue, excessive tiredness .
• Redness of the neck .
• Neck swelling .

Treatment for Ludwigs Angina

Treatment involves appropriate antibiotic medications, monitoring and protection of the airway in severe cases, and, where appropriate, urgent maxillo-facial surgery and/or dental consultation to incise and drain the collections. A nasotracheal tube is sometimes warranted for ventilation if the tissues of the mouth make insertion of an oral airway difficult or impossible.