Ludwig’s Angina

Swelling under the mandible (submandibular)

Floor of mouth and tongue pushed up

What to look for

• Swallowing and breathing difficulty
• Fever and general weakness and tiredness
• Neck pain with redness and swelling. On examination the Tongue may be swollen or lifted out of place if the infection is in the floor of the mouth

Treatment

If the swelling blocks the airway a breathing tube may be put through the mouth or nose and into the lungs. Surgery called a tracheostomy that creates an opening through the neck into the windpipe may also be required. Antibiotics are also given to fight the infection. They are usually given through a vein until symptoms go away and surgery may be needed to drain fluids that are causing the swelling. Removal of the tooth that leads to the infection can then be provided.

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