Ludwig angina

Background

• Infection of the bilateral sublingual and submylohyoid space

Microbiology

• Oral flora, including anaerobes

Clinical Manifestations

• Rapidly-progressive bilateral neck space infection
• Starts with floor of mouth and progresses
• May have swollen tongue

Diagnosis

• Clinical findings with or without supportive imaging

Management

• Airway protection is most important
• Broad-spectrum antibiotics covering oral flora, such as piperacillin-tazobactam or ampicillin-sulbactam, or a cephalosporin plus metronidazole, or clindamycin