Ludwig's angina
| Ludwig's | |
|---|---|
 |
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| Swelling in the submandibular area in a patient with Ludwig's angina. | |
| Classification and external resources | |
| Specialty | gastroenterology |
| ICD-10 | K12.2 |
| ICD-9-CM | 528.3 |
| DiseasesDB | 29336 |
| MedlinePlus | 001047 |
| MeSH | D008158 |
Ludwig's angina, otherwise known as angina ludovici, is a serious, potentially life-threatening cellulitis, or connective tissue infection, of the floor of the mouth, usually occurring in adults with concomitant dental infections and if left untreated, may obstruct the airways, necessitating tracheostomy. It is named after the German physician Wilhelm Friedrich von Ludwig who first described this condition in 1836. Other names include "angina Maligna" and "Morbus Strangularis".
Ludwig's angina should not be confused with angina pectoris, which is also otherwise commonly known as "angina". The word "angina" comes from the Greek word ἀγχόνη ankʰónē, meaning "strangling", so in this case, Ludwig's angina refers to the feeling of strangling, not the feeling of chest pain, though there may be chest pain in Ludwig's angina if the infection spreads into the retrosternal space.
The life-threatening nature of this condition generally necessitates surgical management with involvement of critical care physicians such as those found in an intensive care unit.
Dental infections account for approximately 80% of cases of Ludwig's angina. Mixed infections, due to both aerobes and anaerobes, are of the cellulitis associated with Ludwig's angina. Typically, these include , staphylococci and bacteroides groups.
The route of infection in most cases is from infected lower molars or from pericoronitis, which is an infection of the gums surrounding the partially erupted lower (usually third) molars. Although the widespread involvement seen in Ludwig's usually develops in immunocompromised persons, it can also develop in otherwise healthy individuals. Thus, it is very important to obtain dental consultation for lower-third molars at the first sign of any pain, bleeding from the gums, sensitivity to heat/cold or swelling at the angle of the jaw.
There has been a single case reported where Ludwig's angina was thought to be caused by a recent Tongue piercing. In addition, Filipino boxer Pancho Villa died after contracting Ludwig's Angina following a bout with Jimmy McLarnin.
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Wikipedia