Clinical Spectrum and Microbial Patterns of Ludwig’s Angina:A Cross-Sectional Study

Abstract

Background: Ludwig’s angina is a rapidly progressive cellulitis of the submandibular space that may lead to lifethreatening airway compromise. Understanding its clinical presentation and microbial pattern is essential for early diagnosis and effective management. Objective: To evaluate the clinical spectrum of Ludwig’s angina and its association with microbial pattern, along with socio-demographic characteristics of affected patients. Methods: A hospital-based cross-sectional study was conducted on 50 patients with Ludwig’s angina admitted to three tertiary hospitals in Dhaka between January and June 2014. Patients with other causes of neck swelling, including lymphangioma, haemangioma, cystic hygroma, lymphoma, or submandibular gland neoplasm, were excluded. Data on socio-demographic characteristics, clinical features, and aerobic microbial culture results were collected using a structured data sheet and analyzed to evaluate the clinical profile and microbial pattern of Ludwig’s angina. Results: The mean age of patients was 34.8±17.7 years, with the highest proportion (40%) in the 21-40 years age group. All patients (100%) presented with neck swelling, pain, and tenderness, while fever (90%) and dysphagia (72%) were common systemic and local symptoms. Respiratory distress was observed in only 6% of cases. Aerobic culture showed mixed bacterial growth in 76% and isolated Streptococcal growth in 24% of patients. A significant association was found between gender and microbial pattern (χ²=4.20, p=0.041), with mixed growth more common in males and Streptococcal growth more frequent in females. Mean age was significantly higher in patients with Streptococcal growth (42.5±15.8 years) compared to mixed growth (33.4±17.2 years) (t=2.33, p=0.024). Conclusion: Ludwig’s angina predominantly affected young adult males from lower socioeconomic, rural backgrounds. The infection was mostly polymicrobial, emphasizing the need for broad-spectrum empirical antibiotics, with age and gender significantly influencing microbial patterns

Journal of Dentistry and Allied Science, Vol. 9 No 1: 8-13