Ludwig angina

Discussion:

CT features are in keeping with Ludwig angina (cellulitis floor of mouth) complicated with multiple sites of abscesses. This infection has resulted in elevation and posterior displacement of the tongue resulting in partial stenosis of airway at oral cavity and oropharynx.

The etiology is most likely from odontogenic source (left lower third molar tooth region- recent extraction). Patient has background history of diabetes mellitus on insulin treatment, which was poorly controlled.

Patient went on to have incision and drainage for abscesses as well as vigorous intravenous antibiotics.

Pus culture isolated Klebsiella pneumoniae.

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