Other potential causes include peritonsillar abscess, mandibular fracture, penetrating injury to the floor of the mouth, mandibular osteomyelitis, otitis media, tongue piercing, and sialolithiasis of the submandibular glands . The most common condition that causes Ludwig’s angina is an odontogenic infection.

Patients who are more commonly affected tend to be male, in the fourth decade of life, and from a lower socioeconomic background . It involves the submandibular, sublingual and, submental spaces and tends to spread rapidly along fascial planes. Ludwig's angina is a potentially life-threatening cellulitis of the floor of the mouth and was first described by the German army physician Wilhelm Frederick von Ludwig in 1836 . Early recognition and rapid intervention are paramount in the management of this serious condition. This case is an example of a severe presentation of Ludwig's angina and the difficulties faced by the medical team in managing this condition. Although the patient eventually recovered, his hospital stay was prolonged and marked by multiple complications. He required an emergency surgical airway debridement and extraction of multiple teeth. Upon his index admission, he was found to have Ludwig’s angina with impending airway obstruction. We describe the case of a 57-year-old male with multiple comorbidities who was seen by a provider three times for dental pain prior to his admission for Ludwig's angina. Treatment involves early recognition so that an airway can be secured, initiation of antibiotics, and, finally, potential surgical debridement.

The most feared complication of Ludwig’s angina is airway obstruction. The most common cause is a dental infection, although any other oropharyngeal infection has the potential to develop into Ludwig’s angina. Ludwig's angina is a cellulitis of the submandibular, sublingual, and submental spaces, which tends to spread rapidly along fascial planes.

Ludwig angina