WORLD EMERGENCY MEDICINE SOCIETIES & RELATED

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Thursday, May 9, 2019

Ludwig's Angina

TAMING THE SRU
TAMING THE SRU - May 08, 2019 - By Shawn Hassani
Fig. 2  “Brawny” swelling involving submandibular space typical of Ludwig’s Angina.  [Image from medical-dictionary.thefreedictionary.com/]
..."Ludwig’s angina is a diffuse, rapidly expanding infection of the submandibular space. The submandibular space is subdivided by the mylohyoid muscle into the sublingual space superiorly and the submaxillary space inferiorly. These areas communicate freely without the aid of lymphatics, therefore once an infection is present, it can disseminate quickly. To complicate things further, the spaces of the neck also communicate freely with one another making it easy for infection to spread over a wide area. This gives the potential for submandibular infections to involve the pharyngomaxillary and retropharyngeal spaces with minimal resistance. 
Most cases of Ludwig’s angina are due to dental infections, with the second mandibular molar being the most common site. Other causes include: sialadenitis, injury to the floor of the mouth (ex: frenulum or tongue piercings), peritonsillar abscess, lymphadenitis, infected mandibular fractures, infected abscess of the chin, and oral lacerations..."