Ludwig's Angina

Question 1

What is Ludwig’s angina?

Answer 1

Ludwig’s angina is a serious, potentially life-threatening cellulitis of the submandibular space, often arising from infections of the teeth or oropharynx.

Question 2

How does Ludwig’s angina typically present?

Answer 2

It typically presents bilaterally and can lead to airway obstruction due to rapid swelling.

Question 3

What is the most common etiology of Ludwig’s angina?

Answer 3

Most commonly associated with dental infections, particularly lower molars.

Question 4

What are other potential causes of Ludwig’s angina?

Answer 4

Other causes include:
- Trauma
- Salivary gland infections
- Systemic conditions.

Question 5

What are the clinical features of Ludwig’s angina?

Answer 5

• Bilateral swelling of the submandibular area
• ‘brawny induration’
• Dysphagia
• Odynophagia
• Possibly stridor if airway compromise occurs.

Systemic signs:
- Fever
- Malaise

Question 6

How is Ludwig’s angina diagnosed?

Answer 6

• Primarily clinical
• Imaging (CT scan) may be used to assess the extent of the infection and rule out other pathologies.

Question 7

What is the management for Ludwig’s angina?

Answer 7

1. Immediate airway assessment is crucial.
2. If compromised, intubation or tracheostomy may be necessary.
3. Broad-spectrum intravenous antibiotics (e.g., amoxicillin-clavulanate or clindamycin) should be initiated promptly.
4. Surgical intervention may be required for drainage if there is significant abscess formation.

Question 8

Why is close monitoring essential in Ludwig’s angina cases?

Answer 8

Close monitoring in a hospital setting is essential due to the risk of rapid deterioration.