C1 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

C1 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

Predisposing factors dental caries recent dental treatment sickle cell disease a compromised immune system trauma tongue piercing Am Fam Physician 1999;60:109-12

Etiologic Organisms Common Staphylococcus Streptococcus Bacteroides Atypical Pseudomonas Escherichia coli Klebsiella Enterococcus faecalis Candida Clostridium The most commonly cultured organisms include Staphylococcus, Streptococcus, and Bacteroides species.[3] Patients with immunocompromising conditions, such as HIV, diabetes, transplant recipients, and alcoholics, are at risk for infection from a variety of atypical organisms. Atypical organisms isolated in these patients include Pseudomonas, Escherichia coli, Klebsiella, Enterococcus faecalis, Candida, and Clostridium.[54] Bansal A, Miskoff J, Lis RJ. Otolaryngologic critical care. Crit Care Clin. 2003;19:55-72 Spitalnic SJ, Sucov A. Ludwig's angina: case report and review. J Emerg Med. 1995;13:499-503 Crit Care Clin. 2003;19:55-72 J Emerg Med. 1995;13:499-503