Ludwig Angina
Ludwig angina is an infection of the floor of the mouth that is typically polymicrobial and can lead to airway compromise.
Ludwig angina is a rare infection of the floor of the mouth. Infection is typically mixed with both aerobic and anerobic pathogens.
Symptoms may include throat pain, dysphagia, trismus, and drooling. Swelling can be seen in the submandibular, submental spaces as well as the floor of the mouth. Airway management is a primary concern as displacement of the tongue can lead to airway compromise. Surgical drainage may be needed is some cases
Empiric regimens are typically broad and include anaerobic coverage:
- Penicillin G + Clindamycin
- Ceftriaxone + Clindamycin
- Meropenem
- Pip/Tazo
References:
Kao JK, Yang SC. Ludwig’s angina in children. J Acute Med. 20111;1:23-26. doi.org/10.1016/j.jacme.2011.07.002
Bradly JS (ed.) (2018) Nelson's Pediatric Antimicrobial Therapy 24th edition. Itasca, IL:American Academy of Pediatrics