Ludwig’s angina in pregnancy: A discussion of management challenges

A 19-year-old pregnant woman in her second trimester presented with acute dyspnea, left-sided mandibular swelling, and neck erythema, diagnosed as Ludwig’s angina (LA) – a rare, life-threatening cellulitis of the submandibular space – prompting emergent airway monitoring, broad-spectrum intravenous antibiotics, and multidisciplinary coordination with otorhinolaryngology and obstetric services. Despite initial risks of airway obstruction necessitating preparedness for intubation, clinical improvement allowed incision and drainage of a submandibular abscess, with subsequent resolution of symptoms and preserved fetal well-being. This case underscores the diagnostic and therapeutic challenges posed by LA in pregnancy, where anatomic and immunologic adaptations may hasten disease progression, emphasizing the critical need for rapid intervention, tailored imaging to minimize fetal risk, and collaborative care to balance maternal–fetal safety in this rare obstetric emergency.