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Ludwig’s angina
• Ludwig’s angina is a rapidly progressive, potentially fulminant cellulitis
• involves the sublingual and submandibular spaces
• typically originates from an infected or recently extracted tooth– lower second and third molars
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• Spread of process superiorly and posteriorly elevates floor of mouth and tongue.
• In anterior spread, the hyoid bone limits spread inferiorly, causing a "bull neck" appearance
Am Fam Physician 1999;60:109-12
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Predisposing factors
• dental caries
• recent dental treatment
• sickle cell disease
• a compromised immune system
• trauma
• tongue piercing
Am Fam Physician 1999;60:109-12
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Etiologic Organisms
Common• Staphylococcus• Streptococcus• Bacteroides
Atypical • Pseudomonas• Escherichia coli• Klebsiella• Enterococcus faecalis• Candida• Clostridium
Crit Care Clin. 2003;19:55-72
J Emerg Med. 1995;13:499-503
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