Ludwig's angina is characterized by all the following except -

Since most cases of Ludwig's angina are related to a dental cause, it is not surprising that the bacterial cultures mirror the oral flora. These infections are almost always the result of mixed flora, involving both aerobes and anaerobes. The most commonly reported aerobes are alpha-hemolytic streptococci, followed by staphylococcus. The anaerobic bacteria are peptostreptococcus, Bacteroides, Veillonella and Spirochaeta. Submandibular space infection may also spread posteriorly to the carotid sheath or retropharyngeal space or both, by crossing the lateral pharyngeal space.