Ludwig’s Angina: Paediatric Case Report and Literature Review

Ludwig’s Angina (LA) is an uncommon but potentially fatal cellulitis of the submandibular space, complicated by contiguous spread of infection within the respiratory tract and acute airway obstruction. A 13 month-old female developed LA following upper respiratory tract infection with Parainfluenza-3 virus. There was rapid deterioration due to acute airway obstruction and emergency endoctracheal intubation was necessary. A literature review identified thirty-five paediatric cases of LA with a 14% mortality rate. It occurs predominantly in immunocompetent children with an odontogenic source of infection in a third and unknown source of infection in a third of cases. This is the first reported case of a child with preceding respiratory viral infection who developed LA and it is proposed that respiratory viruses may play a previously unrecognized role in the aetiology of Ludwig’s angina in children.