Ludwig's angina resulting from the infection of an oral malignancy

A case of Ludwig's angina is reported in a 60-year-old woman who was discovered to have squamous-cell carcinoma of the tongue and floor of the mouth during intubation for airway management. This report emphasizes the need to consider infection of oral malignancies of the tongue and floor of the mouth in the etiology of Ludwig's angina when an odontogenous origin cannot be demonstrated. It also illustrates the value of bronchoscopy-directed nasotracheal intubation for diagnosis and airway management in such cases.