Ludwig's Angina

Question 1

ESSENCE

Answer 1

Severe cellulitis involving the floor of the mouth

Usually occurs after tooth abscesses

Question 2

CLINICAL FEATURES

Presentation

Answer 2

• Swelling of tongue
• Pain or tenderness floor of mouth
• Difficulty swallowing
• Drooling
• Neck pain
• Problems with speech

Question 3

INVESTIGATIONS

First line

Answer 3

• Dental x-ray - identify roots of teeth
• CT scan with contrast - identify deep neck space infection

Question 4

MANAGEMENT

General

Answer 4

• Airway management
• Antibiotics - generic such as fluxlocacillin until culture
• Incision and drainage
• Nutritional support