This is a flowchart on Ludwig's angina, covering the etiology, pathophysiology, and manifestations of the disease.

ADDITIONAL TAGS:
No crepitus
Risk factors / SDOH
Cell / tissue damage
Structural factors
Ludwig's angina
Medicine / iatrogenic
Infectious / microbial
Biochem / metabolic
Immunology / inflammation
Signs / symptoms
Tests / imaging / labs
Environmental / toxin
Genetic / hereditary
Flow physiology
Pathophysiology
Etiology
Manifestations
Infected (2nd or 3rd) mandi bular molar (+/ erupted)
Upper airway infection
Acute lingual tonsillitis
Diabetes mellitus
Alcohol use disorder
Immunocompromised
Spreads to sub gingival pocket
Spread to mouth floor musculature
Spread below mylohyoid line to sublingual space
Roots of 2nd, 3rd molars extend to sublingual space
Spread to sub mandibular space
Infxn (cellulitis) of the floor of the mouth
Staphylococcus
Streptococcus
Peptostreptococcus
Fusobacterium
Bacteroides
Actinomyces
Usually polymicrobial, aerobes and anaerobes
Fever
Mouth pain
Stiff neck
Difficulty swallowing
Trismus
Drooling
Hoarse voice
Sore throat
Tongue swelling
Difficulty speaking
Stridor
Sublingual space involvement
Suggest airway obstruction impending
No lymphadenopathy
Crepitus might suggest necrotizing fasciitis
Cyanosis
“Bull neck” appearance: ↑ submental fullness,
↓ mandibular angle
Mediastinitis
Cellulitis of the neck
Aspiration pneumonia
Abscess
Flexible fiberoptic nasal intubation is preferred;
+/ emergency tracheostomy
By Anand H Kulkarni, Swarupa D Pai, Basant Bhattarai, Sumesh T Rao and M Ambareesha http://www.casesjournal.com/content/1..., CC BY 2.0, https://commons.wikimedia.org/w/index...