True about ludwig's angina -

True about ludwig’s angina -
a) Rapidly spreading cellulitis of neck
b) H. Influenzae is most common organism
c) Edema of floor of mouth
d) Sub- lingual and sub- maxillary spaces are involved
e) When operated ?GA chances of aspiration, shock can develop



Clinical features

  • In Ludwig’s angina there is usually cellulitis of the tissue rather than frank abscess.
  • Marked difficulty in swallowing (odynophagia).
  • Varying degrees of trisumus.
  • On involvement of sublingual space, floor of the mouth is swollen, oedematous and tongue seems to be pushed up and back.
  • On involvement of the submaxillary space the submental and submandibular regions become swollen and tender and impart woody- hard feel. Tongue is progressively pushed upwards and backwards threatening the airway.
  • Laryngeal edema may appear.


  • Aspiration pneumonia and septicemia.
  • Airway obstruction due to laryngeal edema or swelling and pushing back of tongue.
  • Spread of infection to parapharyngeal and retropharyngeal space and thence to the mediastinum.