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Ludwig's Angina

Roger G. Finch, MD; George E. Snider Jr, MD; Philip M. Sprinkle, MD
JAMA. 1980;243(11):1171-1173. doi:10.1001/jama.1980.03300370045027.
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LUDWIG'S angina is a life-threatening infection of the sublingual and submandibular spaces, first described by Von Ludwig in 1836. Before the widespread use of antibiotics, the disease seems to have occurred relatively frequently, as evidenced by several large series.1,2 In recent years, scattered case reports make up most of the available information,3,4 suggesting that the disease is now either less commonly seen or recognized.

Mortality has exceeded 50%,2 and fatalities are still reported.5 Our recent experience with six cases of Ludwig's angina seen over a 32-month period has prompted this review. Despite the critical nature of their illness, all of our patients showed a prompt and complete response to treatment. Table 1 summarizes some clinical features present on admission, while Table 2 outlines the roentgenographic, surgical, and antibiotic aspects of the management of these six cases.

Pathogenesis  Ludwig's angina may arise de novo, but this is


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