Ludwig's angina is a bilateral infection of the submandibular space that consists of two compartments in the floor of the mouth, the sublingual space and the submylohyoid (also known as submaxillary) space, first described by the German physician, Wilhelm Frederick von Ludwig in 1836. Severe neck pain and swelling, fever, malaise, dysphagia and stridor are the main symptoms. Causative organisms include many gram negative and anaerobic organisms, streptococci and staphylococci. With progressive swelling of the soft tissues and elevation and posterior displacement of the tongue, the main life-threatening complication of Ludwig's angina is airway obstruction. Prior to the development of antibiotics, mortality for Ludwig's angina exceeded 50%. As a result of antibiotic treatment, along with improved imaging modalities and surgical techniques, mortality at present averages approximately 8%.
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