Ludwig's angina: An alarming radiology challenge

Ludwig's angina is a cellulitis that affects the submandibular, sublingual, and submental regions, fast-spreading along the fascial plane. Ludwig's angina has been classified as a fast-moving, frequently fatal gangrenous cellulitis or necrotizing fasciitis of the neck and mouth floor over the previous 2 centuries. A 60-years old male patient came with a chief complaint of swelling and pain in the neck that radiated to the chest with fever, headache, nausea, and history of toothache, poor oral hygiene, and diabetes mellitus. Ludwig's angina with mediastinitis complication was established by a computed tomography (CT) scan, which was promptly treated and he recovered completely. Imaging is used as one of the tools to help physicians diagnose Ludwig's angina. A trained, multidisciplinary team is required for the treatment of Ludwig's angina because it involves surgical and antibiotic treatment and also resuscitation. A more accurate and timely diagnosis can lead to a better prognosis. In an emergency, a CT scan may be the best imaging choice, although magnetic resonance imaging is superior to a CT scan since it evaluates soft tissue and compartment involvement better.