Ludwig’s angina (LA) is a rare rapidly progressing life-threatening cellulitis of the submandibular neck space. The authors present a case of Ludwig’s angina caused by herpes simplex virus 1 (HSV) in a 15-year-old boy with idiopathic proctocolitis and immunosuppressive therapy. This report is the first to describe HSV-1 related LA in the pediatric population. The patient was successfully treated with acyclovir intravenously with dramatic clinical improvement. The authors conclude that in patients with LA, HSV should be taken into account in the differential diagnosis. The findings provide evidence that HSV contributes significantly to the development of LA in childhood.

        Key words: Ludwig’s angina, herpes simplex virus, acyclovir, idiopatic proctocolitis