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Ludwig's angina is an infection under the tongue at the bottom of the mouth, which can become quite serious if it is not given the proper treatment. It is most often caused by failure to treat infected teeth in the mouth. Bacteria can spread to the tissue under the tongue, as a result. Alternately, this area of the mouth can become infected if an injury occurs in the mouth and is not treated with antibiotics.
The biggest danger with Ludwig's angina is that the affected tissues will begin to swell and cause the airway to be obscured. This can mean that breathing becomes inhibited quickly. Other symptoms that are noted with Ludwig's angina include excessive drooling, noted swelling and/or redness around the neck, pain in the neck, and earache. People may have a fever and some appeared to be confused or have rapid mood changes. Infection can also cause flulike symptoms, and in particular people may feel weak, tired, or be very sleepy. Before swelling blocks the airway, people usually do feel that breathing is more challenging and they may struggle to get air.
Caught in very early stages, the only treatment that might be required is antibiotics to treat the infection, with follow-up to treat any dental problems that may be present. Some people will need much greater intervention if swelling in the airway is so pronounced that breathing is labored or inhibited. There are several potential choices for airway support. A person might require intubation, breathing tube in the throat via the mouth, or might need some oxygen support with a mask or through the nose. In very severe cases, tracheotomy is required because swelling is too great to intubate or allow passage of air from mouth or nose to the lungs; tracheotomy is typically a treatment of last resort, and is usually removed once the infection is cleared.
Prevention of Ludwig's angina isn’t always possible. It does seem more common in people who have serious illnesses like diabetes or HIV. Getting proper dental care may help minimize risk, since it is most often due to abscess or tooth infection. Regular dental cleanings and exams may thus prove the best preventative.
Some people may wonder why Ludwig's angina is so named, since angina is typically associated with pain in the chest. Angina can also mean to squeeze or to strangle. In the case of this illness, continued swelling can literally strangle the patient, cutting off all air. Those who suspect they have this illness should definitely see a doctor right away.