Ludwig's Angina

Abstract

LUDWIG'S angina is a life-threatening infection of the sublingual and submandibular spaces, first described by Von Ludwig in 1836. Before the widespread use of antibiotics, the disease seems to have occurred relatively frequently, as evidenced by several large series.^1,2In recent years, scattered case reports make up most of the available information,^3,4suggesting that the disease is now either less commonly seen or recognized. Mortality has exceeded 50%,²and fatalities are still reported.⁵Our recent experience with six cases of Ludwig's angina seen over a 32-month period has prompted this review. Despite the critical nature of their illness, all of our patients showed a prompt and complete response to treatment. Table 1 summarizes some clinical features present on admission, while Table 2 outlines the roentgenographic, surgical, and antibiotic aspects of the management of these six cases. <h3>Pathogenesis</h3> Ludwig's angina may arise de novo, but this is