Ludwig’s angina: A diagnostic and surgical priority

•Ludwig’s angina is a frequently fatal rapidly progressive necrotizing cellulitis of the floor of the mouth, the throat and the neck.•Ludwig’s angina should not be confused with Lemierre’s syndrome, different in terms of pathophysiology and therapeutic.•We present four cases of severe necrotizing cervical cellulitis notably associated to concomitant self-medication with NSAIDs.•To treat anaerobic bacteria and streptococci, B-lactams(penicillin with βLase inhibitors) +/- combination with clindamycin, should be used.