Ludwig's Angina
Jessica Mason, MD, and Jennifer Farah, MD
Background
- Called “angina” because, like cardiac angina, it causes a choking sensation
- Due to cellulitis of the mouth floor
- Usually caused by dental infection or trauma; often the patient will report a recent dental visit
- Polymicrobial, rapidly progressive, likely Streptococcus and anaerobic
- Tends to spread quickly and bilaterally; can spread into the mediastinum
- Complications
Clinical Findings
- Sickly appearance; oral mucosa has a brawny, meaty appearance
- Drooling
- Dysphagia
- Elevated tongue
- Firm mouth floor
Management
- Manage airway
- Administer broad-spectrum antibiotics
How You Will Be Tested
- Expect to see a picture of someone with recent dental work
- Picture will likely show a large swollen tongue
- Airway management is key to management
- Patient will need broad-spectrum antibiotics and ear/nose/throat evaluation