Causes and risk factors
Dental infection is the commonest predisposing factor for Ludwig’s angina. Anaerobic streptococcus is the causative organism. It can also be caused as a result of some infection in the oral cavity. It can result from a mouth injury.
Clinical presentation
Patient complains of pain, difficulty in swallowing. There is difficulty in breathing, trismus. There is increased salivation. Swelling and edema at the floor of mouth is the presenting feature of Ludwig’s angina. Cellulitis occurs at the floor of the mouth. A brawny, indurated swelling forms under the chin. Swelling and redness of the neck, swelling of tongue is present. Stridor occurs due to laryngeal edema. Associated symptoms include fever, malaise, weakens, fatigue, tiredness. There may be mental changes or confusion due to the disease. Other features such as drooling of saliva, altered voice, and earache may be present.
Investigation
Medical history by the patient and clinical examination by the doctor helps in diagnosis. Culture of the fluid from the affected part is done to identify the causative bacteria. CT scan and/or MRI is advised to confirm swelling on the floor of the mouth.
Treatment
Treatment depends upon the underlying cause. Dental treatment is needed if it is caused due to dental infection. Medical treatment involves administration of antibiotics, NSAIDs, analgesics. Surgical intervention, i.e., incision and drainage is required if suppuration occurs. In case of breathing difficulty, insertion of oral airway is recommended like intubation. Severe cases may require tracheostomy to maintain breathing.
Other Modes of treatment
The other modes of treatment can also be effective in treating Ludwig’s angina. Homoeopathy is a science which deals with individualization and considers a person in a holistic way. This science can be helpful in combating the symptoms. Similarly, the Ayurvedic system of medicine which uses herbal medicines and synthetic derivates is also found to be effective in treating Ludwig’s angina.
