A potentially lethal infection spreading through the tissue layers beneath the jaw
Ludwig's Angina was initially described by the German physician Wilhelm Frederick von Ludwig who in 1836 saw 5 patients with swelling of their neck and tissue under their chin associated with fever and breathing problems.
The symptoms are easy to spot: Patients start to complain about swelling of their cheeks and the tissue below their chin, giving them a bullneck appearance. They have trouble moving their tongue and find it hard to swallow. Some patients, especially children, might have breathing problems. There is often a raging fever. Before the acute phase of the disease starts, they might have complained or suffered from dental caries, a tooth abscess, recent dental treatment, sickle cell disease, a compromised immune system, trauma and tongue piercing.
Starting from its orininal focus, i.e a mandibular tooth, the infection then spreads along the path of least resistance between the two musclebulks that make up the anatomy below the floor of our oral cavity. If this tissue gets infected and swollen, the airway might get compromised and the classic swelling of the tissue below the chin appears. Causative agents are are often mixed as then bacterial flora in our mouths. Alpha-hemolytic streptococci, staphylococci and bacteroides are commonly reported. Other anaerobes such as peptostreptococci, peptococci, Fusobacterium nucleatum, Veillonella species and spirochetes are also seen. Treatment should be swift with intravenous antibiotics and steroids but sometimes surgical decompression is necessary. The patient's airway should always be monitored and safe.
Unfortunately Ludwig's Angina is not as rare as it sounds and is just another important reason to keep your teeth nice and healthy.