[3] Other causes include a parapharyngeal abscess, mandibular fracture, cut or piercing inside the mouth, or submandibular salivary stones.

[5] The infection spreads through the connective tissue of the floor of the mouth and is normally caused by infectious and invasive organisms such as Streptococcus, Staphylococcus, and Bacteroides.

[1] With the advent of antibiotics in 1940s, improved oral and dental hygiene, and more aggressive surgical approaches for treatment, the risk of death due to Ludwig's angina has significantly reduced.

It presents with an acute onset and spreads very rapidly, therefore early diagnosis and immediate treatment planning is vital and lifesaving.

[18] Angioneurotic oedema,[20] lingual carcinoma and sublingual hematoma formation following anticoagulation should be ruled out as possible diagnoses.

Other things to consider include physician experience, available resources, and personnel are critical factors in formulation of a treatment plan.

Airway management has been found to be the most important factor in treating patients with Ludwig's angina,[25] i.e. it is the "primary therapeutic concern".

[24] In this case, pain and swelling in the neck region would usually cause difficulties in eating or swallowing, hence reducing patient's food and fluid intake.

Placing it into context, Ludwig's angina refers to the feeling of strangling and choking, secondary to obstruction of the airway, which is the most serious potential complication of this condition.