Ludwig’s angina - Medtick

Ludwig’s angina

What is it?

Ludwig’s angina is a rare skin infection (severe form cellulitis) that occurs on the floor of the mouth, underneath the tongue.

  • It causes swelling in the tissues under the tongue and in the neck.
  • The swelling can be so severe that it cuts off the person’s airways and prevents them from swallowing saliva.
  • If a person does not receive treatment, Ludwig’s angina can be fatal.

  • This bacterial infection often occurs after an infection of the roots of the teeth (tooth abscess), which is a collection of pus in the centre of a tooth often in the lower molars (especially the second and third).
    • The roots of these teeth are below the level of the attachment of the mylohyoid muscle to the mandible and so infection can spread to the submylohyoid space and then into the submandibular and sublingual space leading to tongue enlargement and airway obstruction.
  • It can also follow after other mouth infections or injuries.
  • This infection is more common in adults than children.
  • Usually, people who get prompt treatment recover fully.

Cause

Treatments 

  • Intravenous drug use

Illicit drugs

 

Symptoms

  • Pain or tenderness in the floor of your mouth, which is underneath your tongue?
  • Swelling that reaches to the floor of your mouth?
  • Tongue swelling that causes your tongue to push against your palate?
  • Tongue may have extreme swelling?
  • Tongue may be out of place?
  • Difficulty swallowing?
  • Drooling?
  • Problems with speech and/or talking?
  • Voice hoarseness (change of voice)?
  • Neck pain and/or swelling of the neck?
  • Redness on the neck?
  • General discomfort (muscle weakness), uneasiness or ill feeling (malaise) and/or fatigue (tiredness)?
  • High temperature greater than 38°C (100°F) or over and/or chills and sweats?
  • Earache?
  • Confusion?

Complications /Information to beware of/General tips:

Do not wait, phone for an ambulance if have or develop:

  • Sepsis
  • Epiglottitis
  • Low blood pressure
  • Septic shock:
    • Rapid heart rate (rapid pulse)
    • Rapid breathing
    • Dilated pupils
    • Pale, cool skin
    • Sweating (diaphoresis)
    • Yawning
  • If shock occurs (whilst awaiting for an ambulance):
    • Lay the person down (if their injuries allow it) and raise and support their legs
    • Use a coat or blanket to keep them warm, but do not cover their face or the burnt area
    • Do not give them anything to eat or drink
  • Breathing difficulties and/or short of breath
  • Chest Pain
  • How to Treat Shock

This condition can lead to:


This condition may show similar symptoms to:

Please talk to your healthcare professional (i.e. Medical Doctor/Dentist) for further advice

Detailed Information

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