No abscess was seen on ultrasonogram. The white blood cell count was elevated, with a shift to the left. Blood culture was sterile. The illness resolved following initial treatment with intravenous oxacillin followed by oral dicloxacillin. Tender swelling in patient in illustrative case 2.
Patient is unable to open mouth.
Note spread of swelling laterally and abrasion on nose in same patient as shown in Figure 2. Case 2 A boy aged 33 months presented to the emergency department because of progressive enlargement under the chin for one day and inability to swallow. Three weeks earlier, he had fallen and injured his nose. On examination, the patient had swelling, erythema and tenderness in the submandibular area. Ludwig's angina was diagnosed clinically, and treatment with intravenous nafcillin was started.