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</div><div><span>Ludwig angina</span></div></div>
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<article><div id="d-article"><div class="page-info"><div class="page-title"><a name="start" id="start">
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</a><h1 class="with-also" itemprop="name">Ludwig angina</h1>
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</noscript></div><div class="main"><div id="ency_summary"><p>Ludwig angina is an infection of the floor of the mouth under the tongue. It is often due to a bacterial infection of the teeth or jaw.</p></div><section><div class="section"><div class="section-header"><div class="section-title"><h2>Causes</h2></div><div class="section-button"><button type="submit" aria-controls="section-1" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-1"><p>Ludwig angina is a type of bacterial infection that occurs in the floor of the mouth, under the tongue. It often develops after an infection of the roots of the teeth (such as <a test="test" href="./001060.htm">tooth abscess</a>) or a mouth injury.</p><p>This condition is uncommon in children.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Symptoms</h2></div><div class="section-button"><button type="submit" aria-controls="section-2" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-2"><p>The infected area swells quickly. This may block the airway or prevent you from swallowing saliva.</p><p>Symptoms include:</p><ul><li>Breathing difficulty</li><li>Difficulty swallowing</li><li>Drooling</li><li>Unusual speech (sounds like the person has a "hot potato" in the mouth)</li><li>Tongue swelling or protrusion of the tongue out of the mouth</li><li>Fever</li><li>Neck pain</li><li>Tooth pain</li><li>Neck swelling</li><li>Redness of the neck</li></ul><p>Other symptoms that may occur with this disease:</p><ul><li>Weakness, fatigue, excess tiredness</li><li>Confusion or other mental changes</li><li><a test="test" href="./003046.htm">Earache</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Exams and Tests</h2></div><div class="section-button"><button type="submit" aria-controls="section-3" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-3"><p>Your health care provider will do an exam of your neck and head to look for redness and swelling of the upper neck, under the chin.</p><p>The swelling may reach to the floor of the mouth. Your tongue may be swollen or pushed up to the top of your mouth.</p><p>You may need a <a test="test" href="./003330.htm">CT scan</a>.</p><p>A sample of the fluid from the tissue may be sent to the lab to test for bacteria.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Treatment</h2></div><div class="section-button"><button type="submit" aria-controls="section-4" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-4"><p>If the swelling blocks the airway, you need to get emergency medical help right away. A breathing tube may needed to be placed through your mouth or nose and into the lungs to restore breathing. You may need to have surgery called a <a test="test" href="./002955.htm">tracheostomy</a> that creates an opening through the neck into the windpipe.</p><p>Antibiotics are given to fight the infection. They are most often given through a vein until symptoms go away. Antibiotics taken by mouth may be continued until tests show that the bacteria have gone away.</p><p>Dental treatment may be needed for tooth infections that cause Ludwig angina.</p><p>Surgery may be needed to drain fluids that are causing the swelling.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Outlook (Prognosis)</h2></div><div class="section-button"><button type="submit" aria-controls="section-5" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-5"><p>Ludwig angina can be life threatening. It can be cured with getting treatment to keep the airways open and taking antibiotic medicine.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Possible Complications</h2></div><div class="section-button"><button type="submit" aria-controls="section-6" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-6"><p>Complications may include:</p><ul><li>Airway blockage</li><li>Generalized infection (<a test="test" href="./000666.htm">sepsis</a>)</li><li><a test="test" href="./000668.htm">Septic shock</a></li></ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>When to Contact a Medical Professional</h2></div><div class="section-button"><button type="submit" aria-controls="section-7" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-7"><p>Breathing difficulty is an emergency situation. Go to the emergency room or contact your local emergency number (such as 911) right away.</p><p>Contact your provider if you have symptoms of this condition, or if symptoms do not get better after treatment.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Prevention</h2></div><div class="section-button"><button type="submit" aria-controls="section-8" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-8"><p>Visit the dentist for regular checkups.</p><p>Treat symptoms of mouth or tooth infection right away.</p></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>Alternative Names</h2></div><div class="section-button"><button type="submit" aria-controls="section-Alt" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Alt"><p>Submandibular space infection; Sublingual space infection; Ludwig's angina</p></div></div></section><section><div class="section sec-mb"><div class="section-header"><div class="section-title"><h2>Images</h2></div><div class="section-button"><button type="submit" aria-controls="section-tnails" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<li><img src="//medlineplus.gov/ency/images/ency/tnails/9555t.jpg" alt="Oropharynx" title="Oropharynx" class="side-img"/><a href="../imagepages/9555.htm">Oropharynx</a></li>
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</ul></div></div></section><section><div class="section"><div class="section-header"><div class="section-title"><h2>References</h2></div><div class="section-button"><button type="submit" aria-controls="section-Ref" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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</div></div><div class="section-body" id="section-Ref"><p>Chow AW. Infections of the oral cavity, neck, and head. In: Bennett JE, Dolin R, Blaser MJ, eds. <em>Mandell, Douglas, and Bennett's Principles and Practice of Infectious Diseases</em>. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 64.</p><p>Christian JM, Felts CB, Beckmann NA, Gillespie MB. Deep neck and odontogenic infections. In: Flint PW, Francis HW, Haughey BH, et al, eds. <em>Cummings Otolaryngology: Head and Neck Surgery</em>. 7th ed. Philadelphia, PA: Elsevier; 2021:chap 9.</p><p>Roginski MA, Atchinson PR. Upper respiratory tract infections. In: Walls RM, ed. <em>Rosen's Emergency Medicine: Concepts and Clinical Practice</em>. 10th ed. Philadelphia, PA: Elsevier; 2023:chap 61.</p></div></div></section>
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<section><div class="section"><div class="section-header"><div class="section-title"><h2>Review Date 3/1/2023</h2></div><div class="section-button"><button type="submit" aria-controls="section-version" role="button" title="Expand/Collapse section"><span class="icon icon-section-action">
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<div id="section-version" class="section-body"><p>Updated by: Josef Shargorodsky, MD, MPH, Johns Hopkins University School of Medicine, Baltimore, MD. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team. </p>
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