Ludwig's Angina Flashcards
What is Ludwig’s angina?
A type of severe cellulitis involving the floor of the mouth
What cause Ludwig’s angina?
Usually a polymicrobial infection involving the flora of the mouth
What are some common causative organisms of Ludwig’s angina?
- Staphylococcus
- Streptococcus
- Peptostreptococcus
What is the most common underlying cause of infection (not organisms) in Ludwig’s angina?
Spread of infection follows a dental infection
What percentage of cases of Ludwig’s angina are preceded by a dental infection?
75-90%
What are some other underlying causes of Ludwig’s angina?
- Oral ulcerations
- Infections of oral malignancy
- Mandible fractures
- Bilateral sialolithiasis-related submandibular gland infection
- Penetrating injuries of mouth floor
What are risk factors for Ludwig’s angina?
- DM
- Malnutrition
- Compromised immune system
- Organ transplantation
How does Ludwig’s angina progress?
Has an acute onset and spreads rapidly
What are the symptoms of Ludwig’s angina?
- Painful neck swelling
- Tooth pain
- Dysphagia
- Shortness of breath
- Fever
- General malaise
What are the potential signs of Ludwig’s angina?
- Bilateral lower facial swelling around mandible and neck
- Elevation of floor of the mouth
- Posterior displacement of the tongue
What can be seen in Ludwig’s angina if airway crisis is impending?
- Stridor
- Cyanosis
- Trismus
What investigations may be useful in Ludwig’s angina?
- Dental x-ray
- CT with contrast
- Chest scan
- Culture of pus
Why can dental x-ray be useful in Ludwig’s angina?
Can identify infections originating in the roots of the teeth
Why can CT neck with contrast be useful in Ludwig’s angina?
Can identify deep neck space infections
Why may a chest scan be needed in Ludwig’s angina?
If suspecting spread to chest cavity