Clinical Presentation and Initial Management of Ludwig’s Angina at Federal Teaching Hospital, Gombe, North East Nigeria

Ludwig's angina is a rapidly progressive, potentially life-threatening bilateral submandibular and sublingual cellulitis that constitutes one of the most serious odontogenic emergencies encountered in oral and maxillofacial surgery practice. Its management demands early recognition, prompt surgical intervention, and appropriate antibiotic therapy. This retrospective descriptive study reviews the clinical presentation, etiological sources, treatment approaches, and outcomes of Ludwig's angina cases managed at the Federal Teaching Hospital, Gombe, North East Nigeria, over a five-year period from 2019 to 2023. A total of 42 confirmed cases were identified from clinical records and theatre logbooks. Data extracted include patient demographics, source tooth, time from symptom onset to presentation, airway compromise status, blood glucose levels, treatment rendered, and hospital length of stay. Results indicate that a dental source was identified in 86% of cases, with the lower second molar being the most common offending tooth. Uncontrolled diabetes mellitus was a significant comorbidity, present in 40% of patients. Airway management by tracheostomy was required in 12 cases. The overall mortality rate in this series was 7.1%, highlighting the continuing burden of this condition in settings with limited intensive care capacity. The findings underscore the need for improved diabetic oral health monitoring programs across the North East zone. Keywords: Ludwig's angina, submandibular cellulitis, odontogenic infection, Gombe, airway management.