UMEM Educational Pearls

Category: Infectious Disease

Title: Ludwig's Angina

Keywords: Ludwig, Angina (PubMed Search)

Posted: 1/13/2008 by Michael Bond, MD (Updated: 7/10/2020)
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 Ludwig’s Angina:

Ludwig’s angina is most commonly a polymicrobial disease of mixed aerobic / anaerobic bacterial origin. Dental disease is the most common cause of Ludwig’s angina.

Diagnosis is usually made after obtaining a CT scan of the Neck and upper chest. 

Once the diagnosis is made, treatment should consist of broad spectrum antibiotics and surgical evaluation by ENT or Oral Surgery for possible I&D. Aggressive management of the patient’s airway is a must, and the patient should be intubated early in the course of the illness if there is any sign of airway compromise. Nasal intubation may be preferred by ENT/Oral Surgery.

Typical Antibiotics include a Penicillin with clindamycin or metronidazole.

Ludwig’s Angina Trivia:

  • Initially described in 1836 by the German physician Wilhelm Frederick von Ludwig.
  • It was called angina, which finds its origin from the Greek word, anchone, which means strangulation.  The term, angina was used to connote throat pain and infection as angina originates from the Greek word, anchone, that means strangulation.
  • It is believed that Elizabeth I of England died of Ludwig's angina in 1603.