• It is a serious, potentially life threatening infection of neck and the floor of the mouth.(Rapidly progressing polymicrobial cellulitis of the sublingual and submandibular spaces.)
• Some of the commonly found microbes are Viridans Streptococci, Staphylococci, Peptostreptococci, Prevotella, Porphyromonas and Fusobacterium.

Etiology

• Odontogenic infection especially from especially from the lower 2nd or 3rd molar
• Sialadentitis
• Peritonsillar abscess
• Epiglottitis
• Open mandibular fracture
• Upper respiratory tract infections
• Trauma to the floor of the mouth
• Oral lacerations
• Infected thyroglossal duct
• Tongue piercing

Predisposing factors

• Dental caries
• Recent dental treatments
• Systemic disorders like diabetes mellitus and compromised immune system like AIDS
• Malnutrition
• Organ transplantation and trauma
• Alcoholism

Symptoms and Diagnosis of Ludwig’s Angina

• Bilateral lower facial swelling around the mandible and upper neck.
• Elevation of the floor of mouth due to sublingual space involvement and posterior displacement of the tongue, creating the potential for a compromised airway.
• painful neck swelling,
• tooth pain & poor oral hygiene
• dysphagia,
• shortness of breath
• Fever & general malaise.
• Stridor, trismus, dysphagia
• cyanosis 
• May exhibit dysphonia
• Bulls neck appearance
• Elevation of tongue

Differential diagnosis

• peritonsillar abscess
• Retropharyngeal abscess,
• Submandibular abscess,
• Epiglottitis,
• Oral carcinoma,
• Angioedema,
• Submandibular hematoma, and
• Diphtheria.

Management of Ludwig’s angina