Ludwig’s angina; COVID-19; airway management; awake fiberoptic intubation


Otorhinolaryngologic Diseases



Ludwig’s angina is a type of severe cellulitis that spreads rapidly and carries a significant risk of airway compromise. Previous complications with COVID-19 are poorly described within the literature.

Case Presentation

This case report describes the complication of COVID-19 infection with suspected Ludwig’s angina 2 days after admission, resulting in awake fibroscopic endotracheal intubation. Emergent treatment and establishing a secure airway are paramount in these cases. We discuss the role of antibiotics and adjunct treatment in these cases of potential airway compromise.


Limited data demonstrate simultaneous infection of COVID-19 with these types of submandibular soft tissue infections in the literature. Previous explorations into this subject are limited, as COVID-19 is a relatively new condition with its own treatment guidelines. We discuss specifically the role of corticosteroid use and surgical intervention in these cases. We wish to highlight awareness and treatment considerations for COVID-19 patients with superimposed Ludwig’s angina.