Ludwig's angina in an otherwise healthy adult

Ludwig angina (LA) is a diagnosis made clinically when a patient with brawny oedema of the submandibular region and inflammatory oedema of the floor of mouth is encountered. This report describes a middle-aged man who developed progressive swelling of the submandibular region and neck. He had restricted mouth opening and pharyngolaryngeal oedema on examination. CT imaging revealed diffuse oedema in all neck compartments with airway narrowing. He improved after medical management with intravenous antibiotics and steroids. Even after thorough investigation, the source of infection remained unidentified. The case highlights the need to manage the airway in all cases clinically diagnosed with LA, and to keep in mind that it may occur in an otherwise healthy adult with no comorbidities.