What bacteria are usually responsible for Ludwig's angina?

From the Research

Ludwig's angina is typically caused by a polymicrobial infection, with anaerobic and aerobic bacteria working together, most commonly streptococci, staphylococci, and anaerobes such as Bacteroides, Peptostreptococcus, Fusobacterium, and Prevotella species. The most recent and highest quality study 1 supports this finding, highlighting the importance of prompt treatment with broad-spectrum antibiotics and airway management to prevent mortality and morbidity.

Key Points

• The infection usually originates from infected lower molars, where bacteria spread from dental infections into the submandibular space 2, 3.
• The polymicrobial nature of the infection explains why broad-spectrum antibiotic coverage is necessary for effective treatment 4, 1.
• Early recognition and treatment are crucial to prevent complications such as airway obstruction, sepsis, and death 1, 5.
• The use of parenteral antibiotics, such as penicillin plus metronidazole, or clindamycin alone, is recommended for effective treatment 2, 3.

Treatment Approach

• Prompt treatment with broad-spectrum antibiotics is essential to prevent mortality and morbidity 1.
• Possible surgical drainage and airway management may be necessary in severe cases 2, 3.
• The patient's airway should be secured, and they should be closely monitored for signs of complications 1, 5.